AUTUMN ROSE CLARK
NPI 1528908688
Counselor - Professional in Marietta, GA
About Autumn Rose Clark NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AUTUMN ROSE CLARK (NPI 1528908688) is an individual professional provider in Marietta, Georgia, licensed in Georgia (APC010509) and active in the NPI registry since March 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Autumn Rose Clark is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Autumn Clark reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Atlanta, GA 30308
- Reassigned Medicare billing, Georgia enrollment
- 38 clinicians in this Medicare group
Atlanta, GA 30308
- Reassigned Medicare billing, Georgia enrollment
- 40 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MARIETTA, GA 30066
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 Autumn Clark's NPI number?
The NPI number for Autumn Clark is 1528908688. It was assigned to this individual provider in the NPPES registry on March 30, 2026.
Where is Autumn Clark located?
Autumn Clark practices at 2440 Sandy Plains Rd Ste 200, Marietta, GA 30066. The listed phone number is (619) 342-5933.
What is Autumn Clark's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Autumn Clark enrolled in Medicare?
Yes. Autumn Clark is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Autumn Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Autumn Clark reassigns Medicare benefits to 2 organizations: Ascend Medical Georgia II PC (Atlanta, GA) and Ascend Medical Georgia PC (Atlanta, GA). Each 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 Autumn Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Autumn Clark was last updated on September 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 33 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.
# Autumn Rose Clark · NPI 1528908688
Professional provider in Marietta, Georgia. Individual provider, active in the CMS NPPES registry since March 30, 2026.
## Identity
- **NPI:** 1528908688 (Entity type: Individual)
- **Enumerated:** March 30, 2026
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** APC010509 (Georgia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2440 SANDY PLAINS RD STE 200, Marietta, GA 30066-7217
- **Phone:** (619) 342-5933
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Ascend Medical Georgia II PC (NPI 1659966075, Atlanta, GA); Ascend Medical Georgia PC (NPI 1841800836, Atlanta, GA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** September 19, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1528908688) · Data from the CMS NPPES public registry.