KATHLEEN MACKENZIE CLARKE NP
NPI 1053863290
Nurse Practitioner - Acute Care in Marietta, GA

Q: What is Kathleen Clarke's NPI number?

The NPI number for Kathleen Clarke is 1053863290. It was assigned to this individual provider in the NPPES registry on November 3, 2016.

Q: What is Kathleen Clarke's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Kathleen Clarke was last updated on April 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 November 03, 2016PECOS EnrolledAccepts Medicare Assignment

92.93/100

CMS Quality Rating

175 WHITE ST NW STE 100, MARIETTA, GA 30060(470) 793-0200 Get Directions Write a Review

NPPES record last updated: April 1, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 1, 2021, Nov 3, 2016 (2 updates tracked since 2016).

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About Kathleen Mackenzie Clarke Np NPPES

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

KATHLEEN MACKENZIE CLARKE NP (NPI 1053863290) is an individual acute care provider in Marietta, Georgia, licensed in Georgia (217411) and active in the NPI registry since November 2016. She is enrolled in Medicare PECOS, is affiliated with Wellstar Kennestone Regional Medical Center, and maintains a secondary practice location in Woodstock.

NPPES Registry Identity

NPI1053863290

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameKATHLEEN MACKENZIE CLARKECredential: NP

Location Address175 WHITE ST NW STE 100Marietta, GA 30060-1054

Mailing Address175 White St Nw Ste 100Marietta, GA 30060-1054 · (470) 793-0200

Phone(470) 793-0200

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateNovember 3, 2016

Last NPPES UpdateApril 1, 20212 updates tracked since enumeration

NPPES CertifiedApril 1, 2021

✔ NPI 1053863290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in GA · 217411

175 WHITE ST NW STE 100, Marietta, GA 30060

Open in Google Maps ↗

Secondary Practice Location 1

Location 1805 Rose Creek WalkWoodstock, GA 30189-6871 · Phone (404) 547-9664

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..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

Kathleen Mackenzie Clarke 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 ID6507135613

PECOS Enrollment IDI20170705003396

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.

Wellstar Kennestone Regional Medical Center

Acute Care Hospitals · Marietta, GA

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110035

Location677 Church StreetMarietta, GA 30060 · Cobb County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30060 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.

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.

92.93/100

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

Scored through an Alternative Payment Model

Quality

80.38

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 5

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

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