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MIRANDA CLARK FNP
NPI 1407528722
Nurse Practitioner - Family in Millington, TN

Active since October 05, 2021PECOS Enrolled
4772 NAVY RD STE A, MILLINGTON, TN 38053(901) 873-0930(901) 873-0931 Get Directions Write a Review

NPPES record last updated: July 20, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 20, 2023, Jul 5, 2023, Oct 11, 2022 and 3 more (6 updates tracked since 2021).

About Miranda Clark Fnp NPPES

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

MIRANDA CLARK FNP (NPI 1407528722) is an individual family provider in Millington, Tennessee, licensed in Tennessee (29697) and active in the NPI registry since October 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in Santa Maria.

NPPES Registry Identity

NPI1407528722
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMIRANDA CLARKCredential: FNP
Location Address4772 NAVY RD STE AMillington, TN 38053-1927
Mailing Address3243 Cypress RdMemphis, TN 38128-6103
Phone(901) 873-0930
Fax(901) 873-0931
Sole ProprietorNo
Enumeration DateOctober 5, 2021
Last NPPES UpdateJuly 20, 20236 updates tracked since enumeration
NPPES CertifiedJuly 20, 2023
✔ NPI 1407528722 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 TN · 29697
4772 NAVY RD STE A, Millington, TN 38053
Open in Google Maps ↗

Secondary Practice Location 1

Location 1135 Carmen LnSanta Maria, CA 93458-7729 · Phone (805) 332-4568 · Fax (800) 417-9245

Other Identifiers 1

Other95021208CA · California Board Of Registered Nursing

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miranda Clark Fnp 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 Reassignments

3

Medicare enrollment records show Miranda Clark reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Hamad Ahmad MD PC
Same address
Family Medicine
4772 NAVY RD, SUITE A
Millington, TN 38053
  • Reassigned Medicare billing, Tennessee enrollment
  • 7 clinicians in this Medicare group
NPI 1588116891 (901) 873-0930
Methodist Healthcare Community Care Associates
14 mi
Urgent Care
8045 CLUB PKWY
Cordova, TN 38016
  • Reassigned Medicare billing, Tennessee enrollment
  • 78 clinicians in this Medicare group
NPI 1194839241 (901) 758-6035
Signify Health Medical Associates, PLLC
431 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Tennessee enrollment
  • 528 clinicians in this Medicare group
NPI 1750845863 (972) 715-3800

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

Areas of Expertise CMS Part B claims

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.
18 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38053 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 9

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

DR. OMAR AHMAD M.D.
Internal Medicine (Hematology & Oncology)
4772 NAVY RD STE A
MILLINGTON, TN 38053
Shelby County (901) 873-0930
TOREY NEDDEN PA-C
Physician Assistant (Medical)
4772 NAVY RD STE A
MILLINGTON, TN 38053
Shelby County (901) 873-0930
KAREN P WILLIAMS APN
Nurse Practitioner (Family)
4772 NAVY RD STE A
MILLINGTON, TN 38053
Shelby County (901) 873-0930
LEEZA TURRI FNP
Nurse Practitioner (Family)
4772 NAVY RD STE A
MILLINGTON, TN 38053
Shelby County (901) 873-0930
MR. IRFAN PRADHAN NP
Nurse Practitioner (Family)
4772 NAVY RD STE A
MILLINGTON, TN 38053
Shelby County (901) 873-0930
MARIAM AYYEH
Physician Assistant
4772 NAVY RD STE A
MILLINGTON, TN 38053
Shelby County (901) 873-0930
DR. FRANK HAMILTON ANDERSON IV MD
Family Medicine
4772 NAVY RD STE A
MILLINGTON, TN 38053
Shelby County (901) 873-0930
MR. JOSHUA STEPHEN WHITE PA
Physician Assistant
4772 NAVY RD STE A
MILLINGTON, TN 38053
Shelby County (901) 873-0930

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 Miranda Clark's NPI number?

The NPI number for Miranda Clark is 1407528722. It was assigned to this individual provider in the NPPES registry on October 5, 2021.

Where is Miranda Clark located?

Miranda Clark practices at 4772 Navy Rd Ste A, Millington, TN 38053. The listed phone number is (901) 873-0930.

What is Miranda Clark's specialty?

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

Is Miranda Clark enrolled in Medicare?

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

Which organizations bill Medicare for Miranda Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Miranda Clark reassigns Medicare benefits to 3 organizations: Hamad Ahmad MD PC (Millington, TN), Methodist Healthcare Community Care Associates (Cordova, TN) and Signify Health Medical Associates, PLLC (Dallas, TX). Each 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 Miranda 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 Miranda Clark was last updated on July 20, 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.