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KERESSA L. CLARK NP
NPI 1346693868
Nurse Practitioner - Family in Kingsport, TN

Active since July 20, 2016PECOS EnrolledAccepts Medicare Assignment
111 W STONE DR, SUITE 110, KINGSPORT, TN 37660(423) 224-3701(423) 224-3709 Get Directions Write a Review

NPPES record last updated: September 14, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 14, 2016, Aug 26, 2016 (2 updates tracked since 2016).

About Keressa L. Clark Np NPPES

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

KERESSA L. CLARK NP (NPI 1346693868) is an individual family provider in Kingsport, Tennessee, licensed in Tennessee (21571) and active in the NPI registry since July 2016. She is enrolled in Medicare PECOS, is affiliated with Charles A Cannon Jr Memorial Hospital, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1346693868
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKERESSA L. CLARKCredential: NP
Location Address111 W STONE DR, SUITE 110Kingsport, TN 37660-6027
Mailing Address105 W Stone Dr, Suite 6aKingsport, TN 37660-3365 · (423) 408-7220 · Fax (423) 408-7405
Phone(423) 224-3701
Fax(423) 224-3709
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJuly 20, 2016
Last NPPES UpdateSeptember 14, 20162 updates tracked since enumeration
✔ NPI 1346693868 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
Licenses✔ Licensed in TN · 21571✔ Licensed in VA · 0024173732
111 W STONE DR, Kingsport, TN 37660
Open in Google Maps ↗

Other Identifiers 2

Medicare PIN10350I7991TN
Medicare PINVVL791B288VA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, UnitedHealthcare.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

Keressa L. Clark Np 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 ID8729373188
PECOS Enrollment IDI20191205000853
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 10

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 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.
345 services275 patients
Injection, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
122 services12 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
106 services106 patients
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.
106 services94 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
102 services87 patients
Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19) and influenza virus types a and b 87636
This test detects the presence of SARS-CoV-2 (COVID-19) and Influenza types A and B in your body. It uses a method called the multiplex amplified probe technique to amplify and identify specific virus genes. It helps in early diagnosis and appropriate treatment.
100 services94 patients

Hospital Affiliations CMS Care Compare

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

Charles A Cannon Jr Memorial Hospital

Critical Access Hospitals · Linville, NC
OwnershipVoluntary non-profit - Private
CMS Certification Number341323
Location434 Hospital DriveLinville, NC 28646 · Avery County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37660 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
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
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.

MR. MICHAEL DAHYL BOGGAN M.D.
General Practice
111 W STONE DR, SUITE 100
KINGSPORT, TN 37660
Sullivan County (423) 247-5197
LARRY J FOSTER M.D.
Internal Medicine (Pulmonary Disease)
111 W STONE DR, SUITE 100
KINGSPORT, TN 37660
Sullivan County (423) 247-5197
PULMONARY ASSOCIATES OF KINGSPORT
Specialist
111 W STONE DR, SUITE 100
KINGSPORT, TN 37660
Sullivan County (423) 247-5197
KATHRYN A. HARRIS NP
Nurse Practitioner (Family)
111 W STONE DR, SUITE 100
KINGSPORT, TN 37660
Sullivan County (423) 247-5197
MORGAN A. CABELL NP
Nurse Practitioner (Family)
111 W STONE DR, SUITE 110
KINGSPORT, TN 37660
Sullivan County (423) 224-3701
LUCINDA MILLER M.D.
Internal Medicine (Pulmonary Disease)
111 W STONE DR, SUITE 100
KINGSPORT, TN 37660
Sullivan County (423) 247-5197
KAYLA J JOYCE NP
Nurse Practitioner (Family)
111 W STONE DR, SUITE 110
KINGSPORT, TN 37660
Sullivan County (423) 224-3701
NEKISHA S. JOHNSON NP
Nurse Practitioner (Family)
111 W STONE DR, SUITE 100
KINGSPORT, TN 37660
Sullivan County (423) 247-5197

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 Keressa Clark's NPI number?

The NPI number for Keressa Clark is 1346693868. It was assigned to this individual provider in the NPPES registry on July 20, 2016.

Where is Keressa Clark located?

Keressa Clark practices at 111 W Stone Dr Suite 110, Kingsport, TN 37660. The listed phone number is (423) 224-3701.

What is Keressa Clark's specialty?

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

Is Keressa Clark enrolled in Medicare?

Yes. Keressa Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Keressa Clark accept?

Health plans from Blue Cross and Blue Shield of NC and UnitedHealthcare list Keressa Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Keressa Clark affiliated with any hospitals?

According to CMS data, Keressa Clark is affiliated with Charles A Cannon Jr Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Keressa Clark was last updated on September 14, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.