Active NPI
Ashley T. Clark, FNP-C
- Family Nurse Practitioner
- Myrtle Beach, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 23387
- Practice address
- 2050 Corporate Centre Dr
Myrtle Beach, SC 29577-7428 - Phone
- (843) 698-3120
- Fax
- (888) 900-2640
- NPI assigned
- Oct 9, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 23387 | SC | Primary |
| Family Nurse Practitioner | 363LF0000X | 4054773 | KY | |
| Family Nurse Practitioner | 363LF0000X | 342372 | AZ | |
| Family Nurse Practitioner | 363LF0000X | RN10048819 | MA |
Addresses
Primary practice location
2050 Corporate Centre Dr
Myrtle Beach, SC 29577-7428
Mailing address
2050 Corporate Centre Dr
Myrtle Beach, SC 29577-7428
Phone (843) 698-3120
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC, KY, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
200 Oceangate
Suite 100
Long Beach, CA 90802-4316
408 Heins Rd
Greeleyville, SC 29056-9405
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4054773 | KY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-South Home Care Services, LLC | Current | Accepting new patients | |
| Heartland Hospice Services LLC | Current | Accepting new patients | |
| HCR Manorcare Medical Services of Florida LLC | Current | Accepting new patients | |
| Heartland Hospice Services, LLC | Current | Accepting new patients | |
| Palmetto Primary Care Physicians, LLC | Current | Accepting new patients | |
| Mid-South Home Care Services, LLC | Current | Accepting new patients | |
| Palmetto Primary Care Physicians, LLC | Current | Accepting new patients | |
| Molina Care Connections, LLC. | Current | Accepting new patients | |
| Palmetto Primary Care Physicians, LLC | Current | Accepting new patients |
Locations
200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666
950 W Bannock St
Ste 1100
Boise, ID 83702
Phone (201) 293-7689
5100 Commerce Crossings Dr
Louisville, KY 40229
Phone (502) 305-6267
655 Brawley School Rd
Ste 200
Mooresville, NC 28117
14748 W Center Rd
Ste 104
Omaha, NE 68144
L2540
Columbus, OH 43260
1401 Main St
Bonneau, SC 29431
Phone (843) 825-3404
7 S Alliance Dr
Ste 211B
Goose Creek, SC 29445
Phone (843) 553-4383
601 Sulphur Springs Rd
Greenville, SC 29617
Phone (828) 246-2721
2050 Corporate Centre Dr
Ste 220
Myrtle Beach, SC 29577
Phone (843) 444-0813
2050 Corporate Centre Dr
Ste 220A
Myrtle Beach, SC 29577
Phone (843) 945-3234
4105 Faber Place Dr
Ste 120
North Charleston, SC 29405
Phone (562) 549-3966
201 Sigma Dr
Ste 100
Summerville, SC 29486
Phone (843) 820-3397
Interoperability endpoints
- aclark17401@direct-prd.molinahealthcare.com
Organizations & group practices 10
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.
-
- Community Based Hospice Care Agency
- Myrtle Beach, SC
- NPI 1457380586
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Myrtle Beach, SC
- NPI 1033990544
-
- Family Medicine Physician
- Charleston, SC
- NPI 1073234928
-
- Family Medicine Physician
- Everett, WA
- NPI 1912235060
-
- Family Medicine Physician
- Goose Creek, SC
- NPI 1346717394
-
- Family Medicine Physician
- Summerville, SC
- NPI 1366123739
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Beltsville, MD
- NPI 1902545270
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Alpharetta, GA
- NPI 1154207769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788393600000",
"number": "1457993677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2050 CORPORATE CENTRE DR",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295777428",
"telephone_number": "843-698-3120",
"fax_number": "888-900-2640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2050 CORPORATE CENTRE DR",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295777428",
"telephone_number": "843-698-3120",
"fax_number": "888-900-2640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "ASHLEY",
"middle_name": "T.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-09",
"last_updated": "2026-09-03",
"certification_date": "2026-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "23387",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KY",
"license": "4054773",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "342372",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MA",
"license": "RN10048819",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; 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.