Courtney B Clark, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

17501 Issued in TN

Practice address

2131 N Locust Ave
Lawrenceburg, TN 38464-4455

Phone

(931) 762-6545

NPI assigned

Jul 23, 2013

Last updated

Apr 29, 2025By the provider in NPPES

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

Other names 1

• Courtney B Clark Former name

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Acacia Dermatology

  • Specialist
  • Lawrenceburg, TN
  • NPI 1528216314
  Medicare reassignment NPD
• Anova Medical Associates, PLC

  • Hospitalist Physician
  • Gallatin, TN
  • NPI 1659849537
  Medicare reassignment NPD
• Maury Regional Medical Group, Inc

  • Family Medicine Physician
  • Columbia, TN
  • NPI 1205886264
  Medicare reassignment NPD
• Maury Regional Hospital Marshall Medical Center

  dba MRMG Spring HIll

  • Rural Health Clinic/Center
  • Spring Hill, TN
  • NPI 1548889850
  NPD

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1376985036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 N LOCUST AVE",
            "city": "LAWRENCEBURG",
            "state": "TN",
            "postal_code": "384644455",
            "telephone_number": "931-762-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 N LOCUST AVE",
            "city": "LAWRENCEBURG",
            "state": "TN",
            "postal_code": "384644455",
            "telephone_number": "931-762-6545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1224 Trotwood Ave",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "TN",
            "postal_code": "384014802",
            "country_code": "US",
            "telephone_number": "931-381-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "COURTNEY",
        "middle_name": "B",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "17501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3710089",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "CLARK",
            "middle_name": "B",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Children's Choice Pediatrics, PLLC
• Catherine Marie Chilton, LPN
• Stacy Green Christensen, LPTA
• Katie Elizabeth Christofidis, MS
• Baylee Nicole Clark
• Kayce Clark, PHARM.D
• Lora Johnson Clark
• Rachael Ann Clark
• Clayton D Wilson MD
• Clayton D Wilson MD Family Practice LLC PLLC (Clayton D Wilson MD Family Medicine)

• Nurse Practitioner in Lawrenceburg, TN
• Providers in Lawrenceburg, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.