BRENDA GAYLE CLARK
NPI 1467679175
Counselor - Addiction (Substance Use Disorder) in Wagoner, OK
About Brenda Gayle Clark NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BRENDA GAYLE CLARK (NPI 1467679175) is an individual addiction (substance use disorder) provider in Wagoner, Oklahoma and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Brenda Gayle Clark is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Brenda Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Muskogee, OK 74403
- Reassigned Medicare billing, Texas enrollment
- 1,047 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Brenda Clark's NPI number?
The NPI number for Brenda Clark is 1467679175. It was assigned to this individual provider in the NPPES registry on April 20, 2007.
Where is Brenda Clark located?
Brenda Clark practices at 109 S. Harrill, Wagoner, OK 74467. The listed phone number is (918) 485-3554.
What is Brenda Clark's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.
Is Brenda Clark enrolled in Medicare?
Yes. Brenda Clark is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Brenda Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Brenda Clark reassigns Medicare benefits to Cherokee Nation (Muskogee, OK). 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 Brenda 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 Brenda Clark was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Brenda Gayle Clark · NPI 1467679175
Addiction (Substance Use Disorder) provider in Wagoner, Oklahoma. Individual provider, active in the CMS NPPES registry since April 20, 2007.
## Identity
- **NPI:** 1467679175 (Entity type: Individual)
- **Enumerated:** April 20, 2007
- **Primary specialty:** Counselor - Addiction (Substance Use Disorder) · taxonomy 101YA0400X
- **Sole proprietor:** No
## Practice location
- **Address:** 109 S. HARRILL, Wagoner, OK 74467-5317
- **Phone:** (918) 485-3554 · **Fax:** (918) 485-8371
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Cherokee Nation (NPI 1841207156, Muskogee, OK), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 8, 2007
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Source: [NPI Profile](https://npiprofile.com/npi/1467679175) · Data from the CMS NPPES public registry.