Ashley Nicole Clark, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

GAA-NP001864 Issued in GA

Practice address

125 McDonald Ave
Cuthbert, GA 39840-5829

Phone

(229) 732-3721

Fax

(229) 732-6528

NPI assigned

Oct 20, 2021

Last updated

Nov 27, 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 1

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Careconnect Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Richland, GA
  • NPI 1063436624
  Medicare reassignment NPD
• Careconnect Health, Inc.

  dba CareConnect Convenient Care

  • Federally Qualified Health Center (FQHC)
  • Sylvester, GA
  • NPI 1811874696
  NPD

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1750044236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 MCDONALD AVE",
            "city": "CUTHBERT",
            "state": "GA",
            "postal_code": "398405829",
            "telephone_number": "229-732-3721",
            "fax_number": "229-732-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MCDONALD AVE",
            "city": "CUTHBERT",
            "state": "GA",
            "postal_code": "398405829",
            "telephone_number": "229-732-3721",
            "fax_number": "229-732-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-20",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "GAA-NP001864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Careconnect Health, Inc. (CareConnect Convenient Care)
• Michael Carr Jr.
• Castle Medical
• John Achibuem Chitoh, FNP
• Clan Logistics LLC
• Linda Mayci Coates
• Emily Dale Cox, LAMFT
• Jeffrey Creel
• Cuthbert Emergency Group, LLC
• Layla Makenzie Douthit

• Family Nurse Practitioner in Cuthbert, GA
• Providers in Cuthbert, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.