EN BONNE SANTE CLINIC LLC
NPI 1952134512
Nurse Practitioner - Family in Mcdonough, GA
About En Bonne Sante Clinic Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EN BONNE SANTE CLINIC LLC (NPI 1952134512) is a healthcare organization registered as a family in Mcdonough, Georgia and active in the NPI registry since August 2024. The organization lists Jeanine Clark, Nurse Practitioner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
En Bonne Sante Clinic Llc 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 En Bonne Sante Clinic LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 En Bonne Sante Clinic LLC's NPI number?
The NPI number for En Bonne Sante Clinic LLC is 1952134512. It was assigned to this organization in the NPPES registry on August 20, 2024.
Where is En Bonne Sante Clinic LLC located?
En Bonne Sante Clinic LLC is located at 17 Hampton St Ste F, Mcdonough, GA 30253. The listed phone number is (239) 443-8018.
What is En Bonne Sante Clinic LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is En Bonne Sante Clinic LLC enrolled in Medicare?
Yes. En Bonne Sante Clinic LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through En Bonne Sante Clinic LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to En Bonne Sante Clinic LLC. 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.
When was this NPI record last updated?
The NPPES record for En Bonne Sante Clinic LLC was last updated on September 26, 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.
# En Bonne Sante Clinic Llc · NPI 1952134512
Family organization in Mcdonough, Georgia. Organization record, active in the CMS NPPES registry since August 20, 2024.
## Identity
- **NPI:** 1952134512 (Entity type: Organization)
- **Enumerated:** August 20, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Jeanine Clark, NURSE PRACTITIONER
## Practice location
- **Address:** 17 HAMPTON ST STE F, Mcdonough, GA 30253-3159
- **Phone:** (239) 443-8018
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 26, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1952134512) · Data from the CMS NPPES public registry.