MRS. RICKETTA CLARK NP
NPI 1558478933
Nurse Practitioner in Memphis, TN

Q: What is Ricketta Clark's NPI number?

The NPI number for Ricketta Clark is 1558478933. It was assigned to this individual provider in the NPPES registry on August 23, 2006. The provider is also known as Ms. Ricketta L Harrell N.P..

Q: What is Ricketta Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Ricketta Clark was last updated on November 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 23, 2006PECOS EnrolledAccepts Medicare Assignment

75.06/100

CMS Quality Rating

880 MADISON AVE, MEMPHIS, TN 38103(901) 490-7929 Get Directions Write a Review

NPPES record last updated: November 9, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 9, 2021, Nov 5, 2021 (2 updates tracked since 2021).

On this page

About Mrs. Ricketta Clark Np NPPES

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

MRS. RICKETTA CLARK NP (NPI 1558478933) is an individual nurse practitioner in Memphis, Tennessee, licensed in Tennessee (7029) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS, is affiliated with Regional One Health, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1558478933

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMRS. RICKETTA CLARKCredential: NP

Location Address880 MADISON AVEMemphis, TN 38103-3409

Mailing Address880 Madison AveMemphis, TN 38103-3409 · (901) 490-7929

Phone(901) 490-7929

Sole ProprietorNo

Medical School CMSOtherGraduated 1998

Enumeration DateAugust 23, 2006

Last NPPES UpdateNovember 9, 20212 updates tracked since enumeration

NPPES CertifiedNovember 9, 2021

✔ NPI 1558478933 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in TN · 7029

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

880 MADISON AVE, Memphis, TN 38103

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Other Names 1

Former Name (1)Ms. Ricketta L Harrell N.p.

Other Identifiers 1

Medicaid3905917TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.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

Mrs. Ricketta 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 ID4880724459

PECOS Enrollment IDI20100608000305

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.

Hospital Affiliations CMS Care Compare

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

Regional One Health

Acute Care Hospitals · Memphis, TN

1/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number440152

Location877 Jefferson AvenueMemphis, TN 38103 · Shelby County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38103 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.

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.

75.06/100

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

Scored as part of a group practice

Quality

56.46

Improvement Activities

Cost

71.87

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.

MICHELLE L RUSH MSN, APRN, BC

Nurse Practitioner (Family)