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DEBRA CLARK PNP
NPI 1336525625
Nurse Practitioner - Pediatrics in Concord, NC

Active since August 10, 2015PECOS Enrolled
1040 VINEHAVEN DR NE, CONCORD, NC 28025(704) 784-1010(704) 784-1013 Get Directions Write a Review

NPPES record last updated: August 2, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 2, 2024, Jul 21, 2022, Jun 23, 2017 and 2 more (5 updates tracked since 2017).

About Debra Clark Pnp NPPES

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

DEBRA CLARK PNP (NPI 1336525625) is an individual pediatrics provider in Concord, North Carolina, licensed in North Carolina (5007863) and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336525625
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameDEBRA CLARKCredential: PNP
Location Address1040 VINEHAVEN DR NEConcord, NC 28025-2438
Mailing Address1040 Vinehaven Dr NeConcord, NC 28025-2438 · (704) 784-1010 · Fax (704) 784-1013
Phone(704) 784-1010
Fax(704) 784-1013
Sole ProprietorNo
Enumeration DateAugust 10, 2015
Last NPPES UpdateAugust 2, 20245 updates tracked since enumeration
NPPES CertifiedAugust 2, 2024
✔ NPI 1336525625 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in NC · 5007863
Also ListedNurse PractitionerTaxonomy 363L00000X · License 5007863 (NC)
1040 VINEHAVEN DR NE, Concord, NC 28025
Open in Google Maps ↗

Other Identifiers 1

Medicaid1336525625NC

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Debra Clark Pnp 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 Debra Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Novant Medical Group Inc
0.4 mi
Family Medicine
964 COPPERFIELD BLVD NE
Concord, NC 28025
  • Reassigned Medicare billing, North Carolina enrollment
  • Medicare enrollment name: Novant Health Medical Group, LLC
  • 2,998 clinicians in this Medicare group
NPI 1629262548 (704) 384-7310

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 28025 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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 2

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

ELLA LITTLE PNP
Nurse Practitioner (Pediatrics)
1040 VINEHAVEN DR NE
CONCORD, NC 28025
Cabarrus County (704) 784-1010
DINUSHI FELDMAN
Nurse Practitioner
1040 VINEHAVEN DR NE
CONCORD, NC 28025
Cabarrus County (704) 784-1010

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 Debra Clark's NPI number?

The NPI number for Debra Clark is 1336525625. It was assigned to this individual provider in the NPPES registry on August 10, 2015.

Where is Debra Clark located?

Debra Clark practices at 1040 Vinehaven Dr NE, Concord, NC 28025. The listed phone number is (704) 784-1010.

What is Debra Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Debra Clark enrolled in Medicare?

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

Which organization bills Medicare for Debra Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Debra Clark reassigns Medicare benefits to Novant Medical Group Inc (Concord, NC). 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 Debra 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 Debra Clark was last updated on August 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.