BYRON KEMP CLARK
NPI 1871392860
Nurse Practitioner - Family in Hattiesburg, MS

Q: What is Byron Kemp Clark's NPI number?

The NPI number for Byron Kemp Clark is 1871392860. It was assigned to this organization in the NPPES registry on March 11, 2025. The provider is doing business as Magnolia Family Wellness Clinic.

Q: What is Byron Kemp 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 Byron Kemp Clark was last updated on June 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.

Active since March 11, 2025

5056 W 4TH ST # 100, HATTIESBURG, MS 39402(601) 410-6525(949) 288-0396 Get Directions Write a Review

NPPES record last updated: June 11, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 11, 2025, May 14, 2025, Mar 25, 2025 and 1 more (4 updates tracked since 2025).

On this page

About Byron Kemp Clark NPPES

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

BYRON KEMP CLARK (NPI 1871392860), doing business as Magnolia Family Wellness Clinic, is a healthcare organization registered as a family in Hattiesburg, Mississippi and active in the NPI registry since March 2025. The organization lists Byron Clark, Office Manager/ Clinic Owner, as its authorized official.

NPPES Registry Identity

NPI1871392860

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameBYRON KEMP CLARK

Location Address5056 W 4TH ST # 100Hattiesburg, MS 39402-1069

Mailing Address5056 W 4th St # 100Hattiesburg, MS 39402-1069 · (601) 410-6525

Phone(601) 410-6525

Fax(949) 288-0396

Organization SubpartNo

Authorized OfficialByron ClarkOffice Manager/ Clinic Owner · (601) 410-6525

Enumeration DateMarch 11, 2025

Last NPPES UpdateJune 11, 20254 updates tracked since enumeration

NPPES CertifiedJune 11, 2025

✔ NPI 1871392860 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

5056 W 4TH ST # 100, Hattiesburg, MS 39402

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Other Names 1

Doing Business AsMagnolia Family Wellness Clinic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Byron Kemp Clark is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Byron Kemp Clark, which bills Medicare for the services this clinician delivers.

Clinician (1)

Nadia Clark, FNP-C

Nurse Practitioner

NPI 1689345506

5056 W 4TH ST # 100
Hattiesburg, MS 39402

(601) 446-2056

✔ PECOS✔ Accepts MedicareSame address

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

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 Byron Kemp Clark's NPI number?

The NPI number for Byron Kemp Clark is 1871392860. It was assigned to this organization in the NPPES registry on March 11, 2025. The provider is doing business as Magnolia Family Wellness Clinic.

Where is Byron Kemp Clark located?

Byron Kemp Clark is located at 5056 W 4th St # 100, Hattiesburg, MS 39402. The listed phone number is (601) 410-6525.

What is Byron Kemp Clark's specialty?

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

Is Byron Kemp Clark enrolled in Medicare?

Yes. Byron Kemp Clark is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Byron Kemp Clark?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Byron Kemp Clark. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Byron Kemp Clark accept?

Health plans from Molina Healthcare list Byron Kemp 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 Byron Kemp Clark was last updated on June 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.