CMS-1500 Box 24J / 33a • NPI
1184387672
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LF0000X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family
Box 32 Service Location & ZIP+4
78 HOSPITAL RD, MACON, MS, 39341-2490
✓ 9-Digit EDI 837 ZIP+4 (39341-2490)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1184387672 (BEVERLY W CLARK, FNP-C) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1184387672)
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Albuterol Sulfate Hfa Albuterol Sulfate | 41 | 22 |
| Allopurinol Allopurinol | 14 | <11 |
| Amlodipine Besylate Amlodipine Besylate | 93 | 28 |
| Amlodipine Besylate-Benazepril Amlodipine Besylate/Benazepril | 12 | <11 |
| Amoxicillin Amoxicillin | 38 | 29 |
| Amoxicillin-Clavulanate Potass Amoxicillin/Potassium Clav | 14 | 13 |
| Atorvastatin Calcium Atorvastatin Calcium | 147 | 38 |
| Azithromycin Azithromycin | 64 | 57 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1184387672 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | BEVERLY W CLARK, FNP-C |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family NUCC Code: 363LF0000X (Nurse Practitioner, Family) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 78 HOSPITAL RD, MACON, MS, 39341-2490 |
| Practice Telephone / Fax | Tel: (662) 361-8338 |
| Administrative Mailing Address | 4735 HIGHWAY 490 RD, MACON, MS, 39341-9366 |
| Enumeration & Last Sync | Enumerated: 2021-10-21 | CMS Record Updated: 2022-01-20 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LF0000X)
What Does Taxonomy Code 363LF0000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LF0000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (BEVERLY W CLARK, FNP-C)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363LF0000X — Nurse Practitioner, FamilyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family | State: MS | License: 904987 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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