JESSICA KATE CLARK APRN
NPI 1417412917
Nurse Practitioner - Psychiatric/Mental Health in Waycross, GA

Q: What is Jessica Clark's NPI number?

The NPI number for Jessica Clark is 1417412917. It was assigned to this individual provider in the NPPES registry on February 8, 2019.

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 April 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 February 08, 2019PECOS EnrolledAccepts Medicare Assignment

1007 MARY ST, WAYCROSS, GA 31503(800) 342-8168 Get Directions Write a Review

NPPES record last updated: April 3, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 3, 2023, Feb 19, 2019, Feb 8, 2019 (3 updates tracked since 2019).

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About Jessica Kate Clark Aprn NPPES

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

JESSICA KATE CLARK APRN (NPI 1417412917) is an individual psychiatric/mental health provider in Waycross, Georgia, licensed in Georgia (RN215514) and active in the NPI registry since February 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1417412917

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameJESSICA KATE CLARKCredential: APRN

Location Address1007 MARY STWaycross, GA 31503-3823

Mailing Address1007 Mary StWaycross, GA 31503-3823 · (800) 342-8168

Phone(800) 342-8168

Sole ProprietorYes

Medical School CMSOtherGraduated 2018

Enumeration DateFebruary 8, 2019

Last NPPES UpdateApril 3, 20233 updates tracked since enumeration

NPPES CertifiedApril 3, 2023

✔ NPI 1417412917 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 · RN215514

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License RN215514 (GA)

1007 MARY ST, Waycross, GA 31503

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama 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 and accepts Medicare assignment

Jessica Kate Clark Aprn 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 ID1951644954

PECOS Enrollment IDI20190514003111

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy with evaluation and management visit, 30 minutes 90833

Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.

48 services11 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

19 services15 patients

Psychiatric diagnostic evaluation with medical services 90792

A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.

13 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31503 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 20

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

MISTY BURCHETTE

Counselor