CLARK FAMILY CARE
NPI 1114594389
Clinic/Center - Primary Care in Sylvania, GA

Active since June 07, 2021CLIA 11D2246866 · Waiver
715 W OGEECHEE ST, SYLVANIA, GA 30467(912) 451-4100(912) 451-4105 Get Directions Write a Review

NPPES record last updated: March 1, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 1, 2023, Jan 18, 2022, Jun 7, 2021 (3 updates tracked since 2021).

About Clark Family Care NPPES

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

CLARK FAMILY CARE (NPI 1114594389) is a healthcare organization registered as a primary care in Sylvania, Georgia and active in the NPI registry since June 2021. The organization holds a CLIA Waiver certificate valid through December 29, 2027 and lists Kendall Clark, Fnp-c, as its authorized official.

NPPES Registry Identity

NPI1114594389
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameCLARK FAMILY CARE LLC
Location Address715 W OGEECHEE STSylvania, GA 30467-8693
Mailing AddressPo Box 194Sylvania, GA 30467-0194 · (912) 451-4100
Fax(912) 451-4105
Organization SubpartNo
Authorized OfficialKendall ClarkFnp-c · (912) 451-4100
Enumeration DateJune 7, 2021
Last NPPES UpdateMarch 1, 20233 updates tracked since enumeration
NPPES CertifiedMarch 1, 2023
NPI 1114594389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
715 W OGEECHEE ST, Sylvania, GA 30467

Other Names 1

Doing Business AsClark Family Care

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2246866

Clark Family Care · Sylvania, GA
Active · expires Dec 29, 2027
CLIA Number11D2246866
Laboratory TypePractitioner Other
Certificate Effective DateDecember 30, 2025
Certificate Expiration DateDecember 29, 2027
Laboratory DirectorKendall Clark
Laboratory Phone(912) 451-4100
Laboratory LocationClark Family Care715 W Ogeechee Street, Sylvania, GA 30467
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Nurse Practitioner (Family)
715 W OGEECHEE ST
SYLVANIA, GA 30467

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clark Family Care LLC's NPI number?

The NPI number for Clark Family Care LLC is 1114594389. It was assigned to this organization in the NPPES registry on June 7, 2021. The provider is doing business as Clark Family Care.

Where is Clark Family Care LLC located?

Clark Family Care LLC is located at 715 W Ogeechee St, Sylvania, GA 30467. The listed phone number is (912) 451-4100.

What is Clark Family Care LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Clark Family Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2246866) is associated with this NPI, valid through December 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Clark Family Care LLC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Clark Family Care LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Clark Family Care LLC was last updated on March 1, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.