Callie Bibb Clark, DNP, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP000357 Issued in GA

Practice address

2258 Wrightsboro Rd Ste 400
Augusta, GA 30904-4788

Phone

(706) 724-4400

Fax

(706) 724-6003

NPI assigned

Jul 30, 2021

Last updated

Oct 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Augusta Hospital Hospital, Augusta, GA, CCN 110028

Merit-based Incentive Payment System (MIPS)

Final score

91.62 of 100Reported as apm

Quality

83.25

Promoting interoperability

100

Improvement activities

40

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Piedmont Cardiology of Atlanta, LLC

  dba Piedmont Heart Institute

  • Cardiovascular Disease Physician
  • Atlanta, GA
  • NPI 1275729691

  Single Specialty

  Medicare reassignment Care Compare group NPD
• University Cardiology Associates LLC

  dba Augusta Heart Associates

  • Cardiovascular Disease Physician
  • Augusta, GA
  • NPI 1902198369

  Single Specialty

  Medicare reassignment NPD
• University Cardiology Associates LLC

  dba Augusta Cardiology Clinic

  • Cardiovascular Disease Physician
  • Augusta, GA
  • NPI 1316239346
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University Health Services,Inc

  dba Piedmont Augusta Hospital

  • General Acute Care Hospital
  • Augusta, GA
  • NPI 1588665566
  Care Compare affiliation

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1194498634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 925",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309030925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2258 WRIGHTSBORO RD STE 400",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044788",
            "telephone_number": "706-724-4400",
            "fax_number": "706-724-6003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "818 Saint Sebastian Way Ste 311",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309012653",
            "country_code": "US",
            "telephone_number": "706-724-3473",
            "fax_number": "706-724-3493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CALLIE",
        "middle_name": "BIBB",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-30",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "254429",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "NP000357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen O. Claiborne, MD
• William Christopher Clance, DMD
• John Simpson Clapp, M.D.
• Annabelle B Clark Marceaux, MD
• Amanda De Castro Clark, MD
• Carly Adriana Clark, RDN
• David M Clark, MD
• Jaela Nicole Clark, LMSW
• Michelle Kipp Clark, APRN
• Monique N Clark

• Nurse Practitioner in Augusta, GA
• Providers in Augusta, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.