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SHAQUENCIANA CLARK
NPI 1265160584
Student in an Organized Health Care Education/Training Program in Douglasville, GA

Active since August 13, 2022PECOS Enrolled
8954 HOSPITAL DR, DOUGLASVILLE, GA 30134(770) 968-6461 Get Directions Write a Review

NPPES record last updated: April 21, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 21, 2026, Aug 13, 2022 (2 updates tracked since 2022).

About Shaquenciana Clark NPPES

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

SHAQUENCIANA CLARK (NPI 1265160584) is an individual student in an organized health care education/training program in Douglasville, Georgia and active in the NPI registry since August 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265160584
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameSHAQUENCIANA CLARK
Location Address8954 HOSPITAL DRDouglasville, GA 30134-2272
Mailing Address8954 Hospital DrDouglasville, GA 30134-2272
Phone(770) 968-6461
Sole ProprietorNo
Enumeration DateAugust 13, 2022
Last NPPES UpdateApril 21, 20262 updates tracked since enumeration
NPPES CertifiedApril 21, 2026
✔ NPI 1265160584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
8954 HOSPITAL DR, Douglasville, GA 30134
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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 (PECOS)

Shaquenciana Clark 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.

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.

AMPARO PYRONNEAU NP
Nurse Practitioner (Family)
8954 HOSPITAL DR, BUILDING B, SUITE 115
DOUGLASVILLE, GA 30134
Douglas County (770) 874-5400
MS. SARAH MURPHY MSPAS, PA-C
Physician Assistant (Medical)
8954 HOSPITAL DR
DOUGLASVILLE, GA 30134
Douglas County (678) 838-2585
NINA SHERIA LAGARDE NP
Nurse Practitioner (Family)
8954 HOSPITAL DR
DOUGLASVILLE, GA 30134
Douglas County (678) 838-2584
LAUREN ROSE BREIDENBACH DPT
Physical Therapist
8954 HOSPITAL DR
DOUGLASVILLE, GA 30134
Douglas County (470) 664-6000
DR. HANNA LEGESSE HIRPO MD
Internal Medicine
8954 HOSPITAL DR
DOUGLASVILLE, GA 30134
Douglas County (678) 838-2585
DR. KEHINDE OPEOLUWA IDOWU M.D
Family Medicine
8954 HOSPITAL DR
DOUGLASVILLE, GA 30134
Douglas County (678) 838-2585
TRI-COUNTY ANESTHESIA, LLC
Anesthesiology
8954 HOSPITAL DR
DOUGLASVILLE, GA 30134
Douglas County (770) 920-6420
MRS. KRISTIN ISABEL GRIGGS PA-C
Physician Assistant (Medical)
8954 HOSPITAL DR
DOUGLASVILLE, GA 30134
Douglas County (943) 202-7120

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 Shaquenciana Clark's NPI number?

The NPI number for Shaquenciana Clark is 1265160584. It was assigned to this individual provider in the NPPES registry on August 13, 2022.

Where is Shaquenciana Clark located?

Shaquenciana Clark practices at 8954 Hospital Dr, Douglasville, GA 30134. The listed phone number is (770) 968-6461.

What is Shaquenciana Clark's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Shaquenciana Clark enrolled in Medicare?

Yes. Shaquenciana Clark is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shaquenciana Clark was last updated on April 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.