JESSICA LANE CLARK PMHNP
NPI 1093387664
Nurse Practitioner - Psychiatric/Mental Health in Athens, GA

Q: What is Jessica Clark's NPI number?

The NPI number for Jessica Clark is 1093387664. It was assigned to this individual provider in the NPPES registry on July 13, 2021.

Q: What is Jessica Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Jessica Clark was last updated on February 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 July 13, 2021PECOS EnrolledAccepts Medicare Assignment

745 S MILLEDGE AVE STE 1A, ATHENS, GA 30605(706) 498-9560(706) 498-9568 Get Directions Write a Review

NPPES record last updated: February 9, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jessica Lane Clark Pmhnp NPPES

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

JESSICA LANE CLARK PMHNP (NPI 1093387664) is an individual psychiatric/mental health provider in Athens, Georgia, licensed in Georgia (APRN-NP222359) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1093387664

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameJESSICA LANE CLARKCredential: PMHNP

Location Address745 S MILLEDGE AVE STE 1AAthens, GA 30605-1292

Mailing Address745 S Milledge Ave Ste 1aAthens, GA 30605-1292 · (706) 498-9560 · Fax (706) 498-9568

Phone(706) 498-9560

Fax(706) 498-9568

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateJuly 13, 2021

Last NPPES UpdateFebruary 9, 2026

NPPES CertifiedFebruary 9, 2026

✔ NPI 1093387664 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in GA · APRN-NP222359

Also ListedRegistered NurseTaxonomy 163W00000X · License RN222359 (GA)

745 S MILLEDGE AVE STE 1A, Athens, GA 30605

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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

Jessica Lane Clark Pmhnp 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 ID1759770126

PECOS Enrollment IDI20211105002205

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 30605 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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 11

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

TONYA DELANEY

Social Worker (Clinical)