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CLARK MEDICAL GROUP, LLC
NPI 1477927192
Family Medicine in Statesboro, GA

Active since November 18, 2015CLIA 11D2107683 · Waiver
117 HILL POND LN, STATESBORO, GA 30458(912) 623-2155(912) 623-2156 Get Directions Write a Review

NPPES record last updated: July 20, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 20, 2020, Nov 18, 2015 (2 updates tracked since 2015).

About Clark Medical Group, Llc NPPES

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

CLARK MEDICAL GROUP, LLC (NPI 1477927192) is a healthcare organization registered as a family medicine in Statesboro, Georgia and active in the NPI registry since November 2015. The organization holds a CLIA Waiver certificate valid through January 19, 2028 and lists Aaron Clark, Owner, as its authorized official.

NPPES Registry Identity

NPI1477927192
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCLARK MEDICAL GROUP, LLC
Location Address117 HILL POND LNStatesboro, GA 30458-0872
Mailing Address117 Hill Pond LnStatesboro, GA 30458-0872 · (912) 623-2155 · Fax (912) 623-2156
Phone(912) 623-2155
Fax(912) 623-2156
Organization SubpartNo
Authorized OfficialAaron ClarkOwner · (912) 623-2155
Enumeration DateNovember 18, 2015
Last NPPES UpdateJuly 20, 20202 updates tracked since enumeration
NPPES CertifiedJuly 20, 2020
✔ NPI 1477927192 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in GA · 66012
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
117 HILL POND LN, Statesboro, GA 30458
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.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 11D2107683

Clark Medical Group, LLC · Statesboro, GA
Active · expires Jan 19, 2028
CLIA Number11D2107683
Laboratory TypePhysician Office
Certificate Effective DateJanuary 20, 2026
Certificate Expiration DateJanuary 19, 2028
Laboratory DirectorLisa M. White
Laboratory Phone(912) 623-2155
Laboratory LocationClark Medical Group, LLC117 Hill Pond Lane, Statesboro, GA 30458
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.

DR. AARON TAYLOR CLARK M.D.
Family Medicine
117 HILL POND LN
STATESBORO, GA 30458
Bulloch County (912) 623-2155

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 Medical Group, LLC's NPI number?

The NPI number for Clark Medical Group, LLC is 1477927192. It was assigned to this organization in the NPPES registry on November 18, 2015.

Where is Clark Medical Group, LLC located?

Clark Medical Group, LLC is located at 117 Hill Pond Ln, Statesboro, GA 30458. The listed phone number is (912) 623-2155.

What is Clark Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Clark Medical Group, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2107683) is associated with this NPI, valid through January 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Clark Medical Group, LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Clark Medical Group, 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 Medical Group, LLC was last updated on July 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.