Ccs Care Clinic LLC
NPI 1649168790ActiveOrganization· Nurse Practitioner, Family· Columbia, TN
Nurse Practitioner, Family in Columbia, Tennessee, registered in NPPES in June 2025. The authorized official on file is Crystal Clark, FNP-BC, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1649168790 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 26, 2025 |
| Last updated in NPPES | Feb 11, 2026 |
| Certified by provider | Feb 11, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TN) |
|---|
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