DONALD LEE CLARK III FNP-BC
NPI 1366090573
Nurse Practitioner - Family in Granite City, IL

Q: What is Donald Clark's NPI number?

The NPI number for Donald Clark is 1366090573. It was assigned to this individual provider in the NPPES registry on August 30, 2019.

Q: What is Donald 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 Donald Clark was last updated on August 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 August 30, 2019PECOS EnrolledAccepts Medicare Assignment

2100 MADISON AVE, GRANITE CITY, IL 62040(618) 798-3000 Get Directions Write a Review

NPPES record last updated: August 30, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Donald Lee Clark Iii Fnp-bc NPPES

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

DONALD LEE CLARK III FNP-BC (NPI 1366090573) is an individual family provider in Granite City, Illinois, licensed in Illinois (209019719) and active in the NPI registry since August 2019. He is enrolled in Medicare PECOS, is affiliated with Jersey Community Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1366090573

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameDONALD LEE CLARK IIICredential: FNP-BC

Location Address2100 MADISON AVEGranite City, IL 62040-4713

Mailing Address8308 Burlington DrTroy, IL 62294-4003 · (618) 402-3946

Phone(618) 798-3000

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateAugust 30, 2019

✔ NPI 1366090573 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 IL · 209019719

2100 MADISON AVE, Granite City, IL 62040

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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

Donald Lee Clark Iii Fnp-bc 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 ID3971835786

PECOS Enrollment IDI20191029000651

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

289 services133 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

205 services178 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

195 services164 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

18 services18 patients

Initial hospital care with same-day admission and discharge with high level of medical decision making, per day, if using time, at least 85 minutes 99236

This service involves a brief hospital stay for a serious health issue. Patients are admitted and discharged on the same day, typically within 55 minutes. It allows for close monitoring and immediate treatment, ensuring optimal care.

14 services14 patients

Hospital Affiliations CMS Care Compare 3

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

Jersey Community Hospital

Acute Care Hospitals · Jerseyville, IL

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number140059

Location400 Maple Summit RoadJerseyville, IL 62052 · Jersey County

Emergency services

Crossroads Community Hospital

Acute Care Hospitals · Mount Vernon, IL

OwnershipProprietary

CMS Certification Number140294

Location8 Doctors Park RdMount Vernon, IL 62864 · Jefferson County

Emergency services

Marshall Browning Hospital

Critical Access Hospitals · Du Quoin, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number141331

Location900 North Washington StreetDu Quoin, IL 62832 · Perry County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62040 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

$88.44 typical visit price

range $56.28 – $173.35

Typical copayment $22.11 (range $14.07 – $43.33)

Most-billed visit code 99203

Established Patient

$99.71 typical visit price

range $17.51 – $139.99

Typical copayment $24.92 (range $4.37 – $34.99)

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.

GRANITE CITY CLINIC CORP

Nurse Anesthetist, Certified Registered