Crystal Clark (NPI# 1427557321, PAC ID# 6305107939) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1427557321 |
| PAC ID by PECOS | 6305107939 |
| Professional Enrollment ID | I20180222002233 |
| Full Name | Crystal Clark |
| Organization Legal Name | KIRBY MEDICAL CENTER |
| Address |
1000 Medical Ctr Dr Monticello IL 61856-2116 |
| Phone Number | 2177621540 |
| Gender | F |
| Graduation Year | 2017 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 6901791144 |
| Number of Group Practice Members | 39 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 141301 | KIRBY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1000 Medical Ctr Dr, Monticello, IL 61856-2116 | 2177621540 | KIRBY MEDICAL CENTER |
| Organization Legal Name | KIRBY MEDICAL CENTER |
| Physicians | 17 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kimberly A Kish | Nurse Practitioner | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Lauren A Coovert | Physician Assistant | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Kinza Gul | Internal Medicine | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Evelyn Huang | Family Medicine | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Raymond Carl Bement | Clinical Social Worker | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| James E Manint | Family Medicine | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Raymond L Burnham | Anesthesiology | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Douglas J Jones | General Surgery | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| David C Liss | Nurse Practitioner | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Santia T Fitzpatrick | Nurse Practitioner | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Street Address |
1000 MEDICAL CTR DR |
| City | MONTICELLO |
| State | IL |
| Zip | 61856-2116 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carey Christiansen Ford | Family Medicine | Acs Primary Care Physicians - Southeast PC | 1000 Medical Ctr Dr, Hardeeville, SC 29927-3446 |
| Kimberly A Kish | Nurse Practitioner | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Lauren A Coovert | Physician Assistant | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Stuart F Baker | Plastic and Reconstructive Surgery | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 | |
| Josh Bowers | Emergency Medicine | Acs Primary Care Physicians - Southeast PC | 1000 Medical Ctr Dr, Hardeeville, SC 29927-3446 |
| Kinza Gul | Internal Medicine | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Evelyn Huang | Family Medicine | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Raymond Carl Bement | Clinical Social Worker | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Paul W Hofferbert | Internal Medicine | South Carolina Group Services, LLC | 1000 Medical Ctr Dr, Hardeeville, SC 29927-3446 |
| James E Manint | Family Medicine | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gay Lynne Adams | Chiropractic | 1109 N State St, Monticello, IL 61856-1175 | |
| Rodney Dc Kruse | Chiropractic | 113 E Washington St, Monticello, IL 61856-1640 | |
| Curtis E Johnson | Optometry | 102 S Charter St, Monticello, IL 61856-1853 | |
| Raymond L Burnham | Anesthesiology | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Douglas J Jones | General Surgery | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| David C Liss | Nurse Practitioner | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Santia T Fitzpatrick | Nurse Practitioner | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Brian C Yocks | Family Medicine | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Megan R Murphy | Physician Assistant | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Anne K Marshall | Physician Assistant | Kirby Medical Center | 1000 Medical Ctr Dr, Monticello, IL 61856-2116 |
| Find all physicians in zip 61856 | |||
| City | MONTICELLO |
| Zip Code | 61856 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | MONTICELLO + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Crystal Clark.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.