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COTENNA D. CLARK
NPI 1801401112
Nurse Practitioner - Gerontology in Atlanta, GA

Active since September 14, 2020PECOS EnrolledAccepts Medicare Assignment
92.26/100
CMS Quality Rating
57 EXECUTIVE PARK SOUTH NE, ATLANTA, GA 30329(404) 712-6929(404) 712-0278 Get Directions Write a Review

NPPES record last updated: December 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 11, 2025, Sep 14, 2020 (2 updates tracked since 2020).

About Cotenna D. Clark NPPES

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

COTENNA D. CLARK (NPI 1801401112) is an individual gerontology provider in Atlanta, Georgia, licensed in Georgia (RN231376) and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS and is a graduate of Emory University School Of Medicine (2019).

NPPES Registry Identity

NPI1801401112
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameCOTENNA D. CLARK
Location Address57 EXECUTIVE PARK SOUTH NEAtlanta, GA 30329-2288
Mailing Address1857 Cameo CtTucker, GA 30084-7002 · (678) 485-1156
Phone(404) 712-6929
Fax(404) 712-0278
Sole ProprietorYes
Medical School CMSEmory University School Of MedicineGraduated 2019
Enumeration DateSeptember 14, 2020
Last NPPES UpdateDecember 11, 20252 updates tracked since enumeration
NPPES CertifiedDecember 11, 2025
✔ NPI 1801401112 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in GA · RN231376
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License RN231376 (GA)
57 EXECUTIVE PARK SOUTH NE, Atlanta, GA 30329
Open in Google Maps ↗

Other Names 1

Former Name (1)Cotenna D Gardner Nurse Practitioner

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

Cotenna D. Clark 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 ID9830581305
PECOS Enrollment IDI20220112001743
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.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes 99350
An established patient home visit is a service where a healthcare professional visits a patient's home for a check-up or treatment. The visit typically lasts for about an hour. This service is especially beneficial for patients who may have difficulty traveling to a healthcare facility.
69 services46 patients
Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
51 services36 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
49 services28 patients
Assessment of and care planning for patient with impaired thought processing, typically 60 minutes 99483
This service involves a thorough evaluation of your thought processes, which may be impacting your daily life. In a typical 50-minute session, a healthcare professional will assess your cognitive abilities, identify any areas of concern, and develop a personalized care plan to help improve your mental function.
32 services32 patients
Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348
An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.
21 services15 patients
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439
Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.
18 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30329 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality73.83
Promoting Interoperability100
Improvement Activities40

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.

PAMELA ELENE GJERDE PT
Physical Therapist
57 EXECUTIVE PARK SOUTH NE, STE 190
ATLANTA, GA 30329
Dekalb County (404) 778-6390
DR. ALAN GEORGE CZARKOWSKI D.O.
Preventive Medicine (Occupational Medicine)
57 EXECUTIVE PARK SOUTH NE, BLDG 57, SUITE 2301
ATLANTA, GA 30329
Dekalb County (404) 498-4775
DAVID M PASION PT
Physical Therapist
57 EXECUTIVE PARK SOUTH NE, SUITE 190
ATLANTA, GA 30329
Dekalb County (404) 778-6390
DR. BHUSHAN S. AGHARKAR M.D.
Psychiatry & Neurology (Psychiatry)
57 EXECUTIVE PARK SOUTH NE, SUITE 360
ATLANTA, GA 30329
Dekalb County (404) 636-0054
CARL HELDMAN PT
Physical Therapist
57 EXECUTIVE PARK SOUTH NE, SUITE 190
ATLANTA, GA 30329
Dekalb County (404) 778-6390

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 Cotenna Clark's NPI number?

The NPI number for Cotenna Clark is 1801401112. It was assigned to this individual provider in the NPPES registry on September 14, 2020. The provider is also known as Cotenna D Gardner Nurse Practitioner.

Where is Cotenna Clark located?

Cotenna Clark practices at 57 Executive Park South NE, Atlanta, GA 30329. The listed phone number is (404) 712-6929.

What is Cotenna Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Cotenna Clark enrolled in Medicare?

Yes. Cotenna 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.

When was this NPI record last updated?

The NPPES record for Cotenna Clark was last updated on December 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.