Cynthia Jill Martin Clark, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN129251 Issued in GA

Practice address

2160 W Elm St
Wrightsville, GA 31096-2014

Phone

(478) 864-3446

Fax

(478) 864-1288

NPI assigned

Aug 31, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Pruitthealth Hospice IncGroup PAC ID 2264344217, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pruitthealth Hospice, Inc

  • Community Based Hospice Care Agency
  • Swainsboro, GA
  • NPI 1013955749
  Medicare reassignment Care Compare group NPD
• Accordia Healthcare LLC

  • Primary Care Clinic/Center
  • Vidalia, GA
  • NPI 1962826511
  Medicare reassignment NPD
• Community Health Care Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Wrightsville, GA
  • NPI 1932150422
  Medicare reassignment NPD
• Community Health Care Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Sandersville, GA
  • NPI 1184515694
  NPD
• Community Health Care Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jeffersonville, GA
  • NPI 1194996421
  NPD
• Pruitthealth Hospice, Inc.

  • Community Based Hospice Care Agency
  • Augusta, GA
  • NPI 1780622902
  NPD
• Pruitthealth Hospice, Inc.

  • Community Based Hospice Care Agency
  • Greenville, NC
  • NPI 1992744361
  NPD
• Physicians at Home PC

  • Internal Medicine Physician
  • Myrtle Beach, SC
  • NPI 1487073193
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1164899787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 S MAIN ST",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304014818",
            "telephone_number": "478-237-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 W ELM ST",
            "city": "WRIGHTSVILLE",
            "state": "GA",
            "postal_code": "310962014",
            "telephone_number": "478-864-3446",
            "fax_number": "478-864-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CYNTHIA",
        "middle_name": "JILL MARTIN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-31",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN129251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA LICENSE",
            "identifier": "RN129251",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary S.E. Alston, MD
• Angels in Flight Recovery Center, Inc.
• Israel D Bryson, M.D.
• Judy Card, LPC
• Ricky Carnell Cason
• Community Health Care Systems, Inc
• Community Health Care Systems, Inc
• Community Health Care Systems, Inc.
• Cook Management Services Inc
• Dva Renal Healthcare Inc

• Family Nurse Practitioner in Wrightsville, GA
• Providers in Wrightsville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.