MARY SUANN CLARK
NPI 1255004271
Nurse Practitioner - Family in Killeen, TX

Q: What is Mary Clark's NPI number?

The NPI number for Mary Clark is 1255004271. It was assigned to this individual provider in the NPPES registry on July 26, 2021.

Q: What is Mary Clark's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Mary Clark was last updated on January 3, 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.

Active since July 26, 2021PECOS EnrolledAccepts Medicare Assignment

3801 SCOTT AND WHITE DR, KILLEEN, TX 76543(254) 680-1100 Get Directions Write a Review

NPPES record last updated: January 3, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 3, 2023, Feb 16, 2022, Jul 26, 2021 (3 updates tracked since 2021).

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About Mary Suann Clark NPPES

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

MARY SUANN CLARK (NPI 1255004271) is an individual family provider in Killeen, Texas, licensed in Texas (1048104) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS, is affiliated with Baylor Scott & White Medical Center - Temple, and maintains a secondary practice location in Killeen.

NPPES Registry Identity

NPI1255004271

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMARY SUANN CLARK

Location Address3801 SCOTT AND WHITE DRKilleen, TX 76543-5252

Mailing AddressPo Box 844658Dallas, TX 75284-4658 · (800) 944-0371 · Fax (254) 215-9722

Phone(254) 680-1100

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJuly 26, 2021

Last NPPES UpdateJanuary 3, 20233 updates tracked since enumeration

NPPES CertifiedJanuary 3, 2023

✔ NPI 1255004271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in TX · 1048104

Also ListedNurse PractitionerTaxonomy 363L00000X · License 1048104 (TX)

3801 SCOTT AND WHITE DR, Killeen, TX 76543

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Secondary Practice Location 1

Location 13202 S W S Young Dr Ste 102Killeen, TX 76542-6538 · Phone (855) 876-7246 · Fax (855) 277-5070

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mary Suann Clark is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4789076993

PECOS Enrollment IDI20220120002123

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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

425 services312 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

51 services46 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

33 services33 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

15 services15 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baylor Scott & White Medical Center - Temple

Acute Care Hospitals · Temple, TX

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450054

Location2401 S 31st StTemple, TX 76508 · Bell County

Emergency services Birthing friendly

Adventhealth Central Texas

Acute Care Hospitals · Killeen, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number450152

Location2201 S Clear Creek RoadKilleen, TX 76542 · Bell County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76543 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

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.

DR. W MICHAEL AVERITT D.O.

Family Medicine