CLARK FAMILY CARE LLC
NPI 1114594389
Clinic/Center - Primary Care in Sylvania, GA
About Clark Family Care Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CLARK FAMILY CARE LLC (NPI 1114594389), doing business as Clark Family Care, is a healthcare organization registered as a primary care in Sylvania, Georgia and active in the NPI registry since June 2021. The organization lists Kendall Clark, Fnp-c, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Clark Family Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Clark Family Care LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Is Clark Family Care LLC enrolled in Medicare?
Yes. Clark Family Care LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Clark Family Care LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Clark Family Care LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 and 1 other insurer 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 October 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 days 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.
# Clark Family Care Llc · NPI 1114594389
Primary Care organization in Sylvania, Georgia. Organization record, active in the CMS NPPES registry since June 7, 2021.
## Identity
- **NPI:** 1114594389 (Entity type: Organization)
- **Enumerated:** June 7, 2021
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Also known as:** Clark Family Care (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Kendall Clark, FNP-C
## Practice location
- **Address:** 715 W OGEECHEE ST, Sylvania, GA 30467-8693
- **Phone:** (912) 451-4100 · **Fax:** (912) 451-4105
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 20, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1114594389) · Data from the CMS NPPES public registry.