PRINCESS CLARK APRN
NPI 1679082549
Nurse Practitioner - Family in Alpharetta, GA

Q: What is Princess Clark's NPI number?

The NPI number for Princess Clark is 1679082549. It was assigned to this individual provider in the NPPES registry on September 23, 2017.

Q: What is Princess Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Princess Clark was last updated on May 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 September 23, 2017PECOS EnrolledAccepts Medicare Assignment

3905 BROOKSIDE PKWY STE 300, ALPHARETTA, GA 30022(770) 442-1911(770) 442-0306 Get Directions Write a Review

NPPES record last updated: May 10, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 10, 2024, Jun 27, 2018, Mar 17, 2018 and 1 more (4 updates tracked since 2017).

On this page

About Princess Clark Aprn NPPES

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

PRINCESS CLARK APRN (NPI 1679082549) is an individual family provider in Alpharetta, Georgia, licensed in Georgia (RN128145) and active in the NPI registry since September 2017. She is enrolled in Medicare PECOS, maintains 4 additional practice locations, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1679082549

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NamePRINCESS CLARKCredential: APRN

Location Address3905 BROOKSIDE PKWY STE 300Alpharetta, GA 30022-4458

Mailing AddressPo Box 80883Athens, GA 30608-0883 · (706) 549-8114 · Fax (404) 384-6807

Phone(770) 442-1911

Fax(770) 442-0306

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateSeptember 23, 2017

Last NPPES UpdateMay 10, 20244 updates tracked since enumeration

NPPES CertifiedMay 10, 2024

✔ NPI 1679082549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in GA · RN128145

3905 BROOKSIDE PKWY STE 300, Alpharetta, GA 30022

Open in Google Maps ↗

Secondary Practice Locations 4

Location 176 Highland Pavilion Ct Ste 133Hiram, GA 30141-3170 · Phone (770) 439-1172 · Fax (706) 378-1204

Location 218 Riverbend Dr SW Ste 120Rome, GA 30161-6019 · Phone (706) 378-1202 · Fax (706) 378-1204

Location 31503 Professional CtDalton, GA 30720 · Phone (706) 281-2121 · Fax (706) 378-1204

Location 41504 N Thornton Ave Ste 107Dalton, GA 30720-8394 · Phone (706) 278-0138

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..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

Princess 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 ID749547578

PECOS Enrollment IDI20171201002138

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30022 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

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

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.

MRS. LUCE W. SOLARI-SUPRENA ARNP, FNP-BC

Nurse Practitioner (Primary Care)