Katrina Ransom Clark, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN150492 Issued in GA

Practice address

120 Walker Dr NW
Milledgeville, GA 31061-9561

Phone

(475) 457-7820

NPI assigned

Aug 28, 2020

Last updated

Aug 28, 2020By 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 1

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
• Direct secure messaging: katrina.clark.1@8042.direct.athenahealth.com

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.

• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Fayetteville, GA
  • NPI 1013313857
  Medicare reassignment Care Compare group NPD
• Antonio Luis, M.D.

  • Psychiatry Physician
  • Milledgeville, GA
  • NPI 1093958050
  Medicare reassignment
• Antonio Luis, M.D., LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milledgeville, GA
  • NPI 1912627126
  NPD
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1356907273
  NPD

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1376156364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WALKER DR NW",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310619561",
            "telephone_number": "475-457-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WALKER DR NW",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310619561",
            "telephone_number": "475-457-7820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATRINA",
        "middle_name": "RANSOM",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN150492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Angela Childre
• Victoria Jeanine Chin-You
• Sung K Choi, M.D.
• Victor Choice, LPN
• Christopher Bowers MD PC
• Claudia Hope Bell
• Dymon Coachman
• Ernesto A Coligado, M.D.
• Collaborative Health Care & TNG Ins
• Collaborative Healthcare

• Psychiatric/Mental Health Nurse Practitioner in Milledgeville, GA
• Providers in Milledgeville, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; 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.