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MS. BONNIE B CLARK NP
NPI 1154355204
Nurse Practitioner - Family in St George, UT

Active since July 11, 2006PECOS Enrolled
1380 E MEDICAL CENTER DR, ST GEORGE, UT 84790(435) 251-1000 Get Directions Write a Review

NPPES record last updated: June 30, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ms. Bonnie B Clark Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. BONNIE B CLARK NP (NPI 1154355204) is an individual family provider in St George, Utah, licensed in Utah (196561-4405) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154355204
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMS. BONNIE B CLARKCredential: NP
Location Address1380 E MEDICAL CENTER DRSt George, UT 84790-2123
Mailing AddressPo Box 30180Salt Lake City, UT 84130-0180 · (435) 251-1000
Phone(435) 251-1000
Sole ProprietorNo
Enumeration DateJuly 11, 2006
Last NPPES UpdateJune 30, 2023
NPPES CertifiedJune 30, 2023
✔ NPI 1154355204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in UT · 196561-4405
1380 E MEDICAL CENTER DR, St George, UT 84790
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Bonnie B Clark Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Bonnie Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ihc Health Services Inc
Same address
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1380 E MEDICAL CENTER DR STE 4500
St George, UT 84790
  • Reassigned Medicare billing, Utah enrollment
  • Also billed through NPI 1093013203 (Utah)
  • 1,729 clinicians in this Medicare group
NPI 1326173394 (435) 251-2700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84790 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. AMY COVINGTON WERRETT
Speech-Language Pathologist
1380 E MEDICAL CENTER DR
ST GEORGE, UT 84790
Washington County (435) 251-1000
MICHAEL LOCKE ETTINGER
Physical Therapist
1380 E MEDICAL CENTER DR
ST GEORGE, UT 84790
Washington County (435) 251-1000
MICHAEL CHRISTENSEN DO
Anesthesiology
1380 E MEDICAL CENTER DR
ST GEORGE, UT 84790
Washington County (435) 251-1000
TRACY R ORR MD
Radiology (Diagnostic Radiology)
1380 E MEDICAL CENTER DR
ST GEORGE, UT 84790
Washington County (435) 688-4000
IHC HEALTH SERVICES INC
Internal Medicine (Hospice and Palliative Medicine)
1380 E MEDICAL CENTER DR
ST GEORGE, UT 84790
Washington County (385) 887-6277
CHRISTOPHER RAY ANDREW NP
Nurse Practitioner
1380 E MEDICAL CENTER DR
ST GEORGE, UT 84790
Washington County (435) 251-1000
HOLLY ANN RANDALL
Social Worker
1380 E MEDICAL CENTER DR
ST GEORGE, UT 84790
Washington County (435) 251-1000
DYLAN KRUPP PHARMD
Pharmacist
1380 E MEDICAL CENTER DR
ST GEORGE, UT 84790
Washington County (435) 251-4636

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bonnie Clark's NPI number?

The NPI number for Bonnie Clark is 1154355204. It was assigned to this individual provider in the NPPES registry on July 11, 2006.

Where is Bonnie Clark located?

Bonnie Clark practices at 1380 E Medical Center Dr, St George, UT 84790. The listed phone number is (435) 251-1000.

What is Bonnie Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Bonnie Clark enrolled in Medicare?

Yes. Bonnie Clark is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Bonnie Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bonnie Clark reassigns Medicare benefits to Ihc Health Services Inc (St George, UT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Bonnie Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Bonnie Clark was last updated on June 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.