Jessica Lynn Clark, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME127249 Issued in FL

Practice address

600 Grand Panama Blvd Ste 104
Panama City Beach, FL 32407-3459

Phone

(850) 238-8511

Fax

(850) 238-8873

NPI assigned

Jun 5, 2008

Sex

Female

Sole proprietor

No

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 FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Texas a & M University System, HSC, College of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Andrew D McAllister DO PAGroup PAC ID 7810140084, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Andrew D McAllister, DO, PA

  • Plastic Surgery Physician
  • Panama City Beach, FL
  • NPI 1720346760
  Medicare reassignment Care Compare group NPD
• Coastal Skin Surgery and Dermatology, PL

  • MOHS-Micrographic Surgery Physician
  • Miramar Beach, FL
  • NPI 1114238193

  Dermatology

  Medicare reassignment NPD
• Jessica L Clark MD LLC

  • Dermatology Physician
  • Panama City Beach, FL
  • NPI 1184342578
  Medicare reassignment

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1740449719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 GRAND PANAMA BLVD STE 104",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324073459",
            "telephone_number": "850-238-8511",
            "fax_number": "850-654-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRAND PANAMA BLVD STE 104",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324073459",
            "telephone_number": "850-238-8511",
            "fax_number": "850-238-8873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME127249",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "N3566",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Buddy Kyle Chesnut, RPH
• Chiropractic Worx Inc
• Jacob Ryan Chizmar, RN
• CHP Panama City FL Tenant Corp.
• Jennifer Lynn Christensen, MPT
• Suzanne Clark, LCSW
• Payson Elizabeth Clifford
• Coastal Counseling PCB, LLC
• Coastal Family Practice & Acute Care Center LLC
• Coastal Internal Medicine, LLC

• Dermatology Physician in Panama City Beach, FL
• Providers in Panama City Beach, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.