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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACQUELYN SUE GRACE CLARK DO
NPI 1780334656
Family Medicine in Crossett, AR

Active since March 24, 2022PECOS EnrolledAccepts Medicare Assignment
909 UNITY RD STE B, CROSSETT, AR 71635(870) 364-9111(870) 364-1598 Get Directions Write a Review

NPPES record last updated: September 30, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jacquelyn Sue Grace Clark Do NPPES

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

JACQUELYN SUE GRACE CLARK DO (NPI 1780334656) is an individual family medicine provider in Crossett, Arkansas, licensed in Arkansas (E-19213) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2022).

NPPES Registry Identity

NPI1780334656
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameJACQUELYN SUE GRACE CLARKCredential: DO
Location Address909 UNITY RD STE BCrossett, AR 71635-9444
Mailing Address909 Unity Rd Ste BCrossett, AR 71635-9444 · (870) 364-9111 · Fax (870) 364-1598
Phone(870) 364-9111
Fax(870) 364-1598
Sole ProprietorYes
Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 2022
Enumeration DateMarch 24, 2022
Last NPPES UpdateSeptember 30, 2026
NPPES CertifiedSeptember 30, 2026
✔ NPI 1780334656 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in AR · E-19213
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.
909 UNITY RD STE B, Crossett, AR 71635
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacquelyn Sue Grace Clark Do 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 ID4880081199
PECOS Enrollment IDI20250729004884
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.

Medicare Billing Reassignment

Medicare enrollment records show Jacquelyn Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Crossett Health Foundation
Same address
Rural Health
909 UNITY RD STE B
Crossett, AR 71635
  • Reassigned Medicare billing, Arkansas enrollment
  • 10 clinicians in this Medicare group
NPI 1639159973 (870) 364-9111

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 71635 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
$79.72 typical visit price
range $51.36 – $157.74
Typical copayment $19.93 (range $12.84 – $39.43)
Most-billed visit code 99203
Established Patient
$91.63 typical visit price
range $16.16 – $128.77
Typical copayment $22.90 (range $4.04 – $32.19)
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 5

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

JULIE LEANNE BAYS APN
Nurse Practitioner (Family)
909 UNITY RD STE B
CROSSETT, AR 71635
Ashley County (870) 364-9111
CROSSETT HEALTH FOUNDATION
Clinic/Center (Rural Health)
909 UNITY RD STE B
CROSSETT, AR 71635
Ashley County (870) 364-9111
DR. KHALIF D BALL MD
Student in an Organized Health Care Education/Training Program
909 UNITY RD STE B
CROSSETT, AR 71635
Ashley County (870) 364-9111
DR. BRADLEY JEFFERSON WALSH MD
Family Medicine
909 UNITY RD STE B
CROSSETT, AR 71635
Ashley County (870) 364-9111
DR. ALI AMJAD MD
Student in an Organized Health Care Education/Training Program
909 UNITY RD STE B
CROSSETT, AR 71635
Ashley County (870) 364-9111

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 Jacquelyn Clark's NPI number?

The NPI number for Jacquelyn Clark is 1780334656. It was assigned to this individual provider in the NPPES registry on March 24, 2022.

Where is Jacquelyn Clark located?

Jacquelyn Clark practices at 909 Unity Rd Ste B, Crossett, AR 71635. The listed phone number is (870) 364-9111.

What is Jacquelyn Clark's specialty?

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

Is Jacquelyn Clark enrolled in Medicare?

Yes. Jacquelyn Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jacquelyn Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacquelyn Clark reassigns Medicare benefits to Crossett Health Foundation (Crossett, AR). The 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 Jacquelyn Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jacquelyn Clark accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Jacquelyn Clark 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 Jacquelyn Clark was last updated on September 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 24 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.