COURTNEY A CLARK DO
NPI 1790100113
Pediatrics in Picayune, MS
About Courtney A Clark Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
COURTNEY A CLARK DO (NPI 1790100113) is an individual pediatrics provider in Picayune, Mississippi, licensed in Mississippi (29407) and active in the NPI registry since February 2014. She is enrolled in Medicare PECOS and maintains a secondary practice location in Jacksonville.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Courtney A Clark Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Courtney Clark reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Picayune, MS 39466
- Reassigned Medicare billing, Mississippi enrollment
- 326 clinicians in this Medicare group
Pearl River, LA 70452
- Reassigned Medicare billing, Louisiana enrollment
- 4,559 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 39466 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 13
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Courtney Clark's NPI number?
The NPI number for Courtney Clark is 1790100113. It was assigned to this individual provider in the NPPES registry on February 21, 2014.
Where is Courtney Clark located?
Courtney Clark practices at 2274 Highway 43 S, Picayune, MS 39466. The listed phone number is (601) 347-9024.
What is Courtney Clark's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Courtney Clark enrolled in Medicare?
Yes. Courtney Clark is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Courtney Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Courtney Clark reassigns Medicare benefits to 2 organizations: Ochsner Mississippi, LLC (Picayune, MS) and Ochsner Clinic LLC (Pearl River, LA). 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 Courtney Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Courtney Clark accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 2 other insurers list Courtney 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 Courtney Clark was last updated on November 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Courtney A Clark, DO · NPI 1790100113
Pediatrics physician in Picayune, Mississippi. Individual provider, active in the CMS NPPES registry since February 21, 2014.
## Identity
- **NPI:** 1790100113 (Entity type: Individual)
- **Enumerated:** February 21, 2014
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 29407 (Mississippi)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2274 HIGHWAY 43 S, Picayune, MS 39466-8141
- **Phone:** (601) 347-9024 · **Fax:** (601) 798-5914
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Ochsner Mississippi, LLC (NPI 1881296036, Picayune, MS); Ochsner Clinic LLC (NPI 1326432337, Pearl River, LA) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 15, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1790100113) · Data from the CMS NPPES public registry.