BROOKE CRAWFORD CLARK
NPI 1417540022
Nurse Practitioner - Family in Fayetteville, NC

Q: What is Brooke Clark's NPI number?

The NPI number for Brooke Clark is 1417540022. It was assigned to this individual provider in the NPPES registry on February 15, 2021.

Q: What is Brooke 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 Brooke Clark was last updated on February 27, 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 February 15, 2021PECOS Enrolled

98.33/100

CMS Quality Rating

2940 BREEZEWOOD AVE, FAYETTEVILLE, NC 28303(252) 261-8040 Get Directions Write a Review

NPPES record last updated: February 27, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 27, 2023, Feb 15, 2021 (2 updates tracked since 2021).

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About Brooke Crawford Clark NPPES

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

BROOKE CRAWFORD CLARK (NPI 1417540022) is an individual family provider in Fayetteville, North Carolina, licensed in North Carolina (5014068) and active in the NPI registry since February 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417540022

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameBROOKE CRAWFORD CLARK

Location Address2940 BREEZEWOOD AVEFayetteville, NC 28303-5520

Mailing AddressPo Box 1362Manteo, NC 27954-1362 · (252) 573-0079

Phone(252) 261-8040

Sole ProprietorNo

Enumeration DateFebruary 15, 2021

Last NPPES UpdateFebruary 27, 20232 updates tracked since enumeration

NPPES CertifiedFebruary 27, 2023

✔ NPI 1417540022 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 NC · 5014068

2940 BREEZEWOOD AVE, Fayetteville, NC 28303

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Brooke Crawford Clark 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

Medicare enrollment records show Brooke Clark reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Universal Health Corporation

164 mi

Internal Medicine

130 CHURCH AVE SW
Roanoke, VA 24011

Reassigned Medicare billing, North Carolina enrollment
80 clinicians in this Medicare group

NPI 1407117625 (540) 769-3964

Signify Health Medical Associates, PLLC

1,038 mi

General Practice

4055 VALLEY VIEW LN STE 700
Dallas, TX 75244

Reassigned Medicare billing, North Carolina enrollment
728 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28303 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

98.33/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

82.93

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

3 suppliers16 claims480 services$0.09 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers17 claims17 services$215.30 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

3 suppliers13 claims13 services$24.19 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

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

MISS LIANDRA MERCEDIS WHEELER LPA

Psychologist (Clinical)