Individual provider Active NPI

Ashley T. Clark, FNP-C

  • Family Nurse Practitioner
  • Myrtle Beach, SC
National Provider Identifier
1457993677
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23387 Issued in SC
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

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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, WA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200106003058 SC Practitioner - Nurse Practitioner 8628402229 Reassigns benefits to 5 organizations
I20260410001026 KY Practitioner - Nurse Practitioner 8628402229 Reassigns benefits to 1 organization
I20260423001858 WA Practitioner - Nurse Practitioner 8628402229 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
4054773KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Home Care Services, LLC CurrentSince Oct 31, 2023 Accepting new patients
Heartland Hospice Services LLC CurrentSince Aug 29, 2023 Accepting new patients
HCR Manorcare Medical Services of Florida LLC CurrentSince Mar 1, 2021 Accepting new patients
Heartland Hospice Services, LLC CurrentSince Aug 29, 2023 Accepting new patients
Palmetto Primary Care Physicians, LLC Current Accepting new patients
Mid-South Home Care Services, LLC CurrentSince Oct 31, 2023 Accepting new patients
Palmetto Primary Care Physicians, LLC CurrentSince Nov 8, 2019 Accepting new patients
Molina Care Connections, LLC. CurrentSince Nov 11, 2024 Accepting new patients
Palmetto Primary Care Physicians, LLC CurrentSince Nov 8, 2019 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.