MANDY CLARK APRN
NPI 1104426261
Nurse Practitioner - Pediatrics in Springdale, AR

Q: What is Mandy Clark's NPI number?

The NPI number for Mandy Clark is 1104426261. It was assigned to this individual provider in the NPPES registry on October 28, 2020.

Q: What is Mandy Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Mandy Clark was last updated on December 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 October 28, 2020PECOS Enrolled

614 E EMMA AVE STE 300, SPRINGDALE, AR 72764(479) 751-7417 Get Directions Write a Review

NPPES record last updated: December 6, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 6, 2023, Oct 28, 2020 (2 updates tracked since 2020).

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About Mandy Clark Aprn NPPES

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

MANDY CLARK APRN (NPI 1104426261) is an individual pediatrics provider in Springdale, Arkansas, licensed in Arkansas (A006213) and active in the NPI registry since October 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104426261

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameMANDY CLARKCredential: APRN

Location Address614 E EMMA AVE STE 300Springdale, AR 72764-4469

Mailing Address614 E Emma Ave Ste 300Springdale, AR 72764-4469 · (479) 409-6330

Phone(479) 751-7417

Sole ProprietorNo

Enumeration DateOctober 28, 2020

Last NPPES UpdateDecember 6, 20232 updates tracked since enumeration

NPPES CertifiedJune 30, 2022

✔ NPI 1104426261 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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

Taxonomy Code363LP0200X

License✔ Licensed in AR · A006213

614 E EMMA AVE STE 300, Springdale, AR 72764

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mandy Clark Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 72764 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

$79.72 typical visit price

range $51.36 – $157.74

Typical copayment $19.93 (range $12.84 – $39.43)

Most-billed visit code 99203

Established Patient

$91.63 typical visit price

range $16.16 – $128.77

Typical copayment $22.90 (range $4.04 – $32.19)

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.

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Other Providers at the Same Location NPPES 20

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

GRANT BRENNAN OSEROWSKY DDS

Dentist (General Practice)