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MRS. SHANTERA CLARK FNP-C
NPI 1962020057
Nurse Practitioner - Family in Statesboro, GA

Active since July 06, 2020PECOS EnrolledAccepts Medicare Assignment
630 OGEECHEE DR W, STATESBORO, GA 30461(478) 456-0238 Get Directions Write a Review

NPPES record last updated: August 4, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 4, 2022, Jul 6, 2020 (2 updates tracked since 2020).

About Mrs. Shantera Clark Fnp-c NPPES

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

MRS. SHANTERA CLARK FNP-C (NPI 1962020057) is an individual family provider in Statesboro, Georgia, licensed in Georgia (RN220889) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1962020057
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. SHANTERA CLARKCredential: FNP-C
Location Address630 OGEECHEE DR WStatesboro, GA 30461-6753
Mailing AddressPo Box 1964Statesboro, GA 30459-1964 · (478) 456-0238
Phone(478) 456-0238
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateJuly 6, 2020
Last NPPES UpdateAugust 4, 20222 updates tracked since enumeration
NPPES CertifiedAugust 4, 2022
✔ NPI 1962020057 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
License✔ Licensed in GA · RN220889
630 OGEECHEE DR W, Statesboro, GA 30461
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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

Mrs. Shantera Clark Fnp-c 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 ID6608274527
PECOS Enrollment IDI20211007001273
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 4

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
169 services57 patients
Psychotherapy with evaluation and management visit, 30 minutes 90833
Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.
104 services48 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
35 services31 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30461 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

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 Shantera Clark's NPI number?

The NPI number for Shantera Clark is 1962020057. It was assigned to this individual provider in the NPPES registry on July 6, 2020.

Where is Shantera Clark located?

Shantera Clark practices at 630 Ogeechee Dr W, Statesboro, GA 30461. The listed phone number is (478) 456-0238.

What is Shantera Clark's specialty?

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

Is Shantera Clark enrolled in Medicare?

Yes. Shantera 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 Shantera Clark was last updated on August 4, 2022. 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.