JEANINE CLARK FNP
NPI 1023509452
Nurse Practitioner - Family in Stockbridge, GA

Q: What is Jeanine Clark's NPI number?

The NPI number for Jeanine Clark is 1023509452. It was assigned to this individual provider in the NPPES registry on May 21, 2018.

Q: What is Jeanine Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Jeanine Clark was last updated on August 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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 May 21, 2018PECOS EnrolledAccepts Medicare Assignment

175 MEDICAL BLVD, STOCKBRIDGE, GA 30281(239) 443-8018 Get Directions Write a Review

NPPES record last updated: August 20, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 20, 2024, Mar 17, 2023, Feb 24, 2020 and 1 more (4 updates tracked since 2018).

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About Jeanine Clark Fnp NPPES

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

JEANINE CLARK FNP (NPI 1023509452) is an individual family provider in Stockbridge, Georgia, licensed in Georgia (RN243362) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1023509452

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameJEANINE CLARKCredential: FNP

Location Address175 MEDICAL BLVDStockbridge, GA 30281-5083

Mailing Address17 Hampton St Ste FMcdonough, GA 30253-3159 · (239) 443-8018

Phone(239) 443-8018

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateMay 21, 2018

Last NPPES UpdateAugust 20, 20244 updates tracked since enumeration

NPPES CertifiedAugust 20, 2024

✔ NPI 1023509452 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in GA · RN243362

175 MEDICAL BLVD, Stockbridge, GA 30281

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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

Jeanine Clark Fnp 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 ID8921437997

PECOS Enrollment IDI20200326003998

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30281 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

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

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.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ATLANTA VAMC

Clinic/Center (VA)