Jessica Kate Clark, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN215514 Issued in GA

Practice address

1007 Mary St
Waycross, GA 31503-3823

Phone

(800) 342-8168

NPI assigned

Feb 8, 2019

Last updated

Apr 3, 2023By 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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Unison Behavioral HealthGroup PAC ID 7517852247, 19 clinicians

K Somanath MD IncGroup PAC ID 8022488469, 9 clinicians

Practice addresses (Care Compare)

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.

• Unison Behavioral Health

  • Community/Behavioral Health Agency
  • Waycross, GA
  • NPI 1528104866
  Medicare reassignment Care Compare group NPD
• K Somanath MD Inc

  dba Psychiatry Treatment Centers

  • Psychiatry Physician
  • Los Angeles, CA
  • NPI 1649998022

  GA, Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Renewed Hope Health & Wellness, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jesup, GA
  • NPI 1740026541
  Medicare reassignment NPD
• Unison Behavioral Health

  • Community/Behavioral Health Agency
  • Douglas, GA
  • NPI 1194861443
  NPD
• Unison Behavioral Health

  • Counselor
  • Homerville, GA
  • NPI 1427368539
  NPD

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

{
    "created_epoch": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1417412917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 MARY ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315033823",
            "telephone_number": "800-342-8168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 MARY ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315033823",
            "telephone_number": "800-342-8168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3455 Harris Rd",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315038960",
            "country_code": "US",
            "telephone_number": "800-342-8168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JESSICA",
        "middle_name": "KATE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-08",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN215514",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN215514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Hall Host Home
• David H Cheatham, MD
• Taylor Elizabeth Chesser, FNP-C
• Sohail A Choudhri, M.D.
• Christine Smith
• Lewis Grant Clark III, PHARMACIST
• Spurgeon William Clark III, M. D.
• Clinical Diagnostic Services
• CLS Comp
• Coastal Care Inc

• Psychiatric/Mental Health Nurse Practitioner in Waycross, GA
• Providers in Waycross, 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 Apr 3, 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.