Janae Alise Clark, APRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

APRN-NP719288 Issued in GA

Practice address

1107 Memorial Dr Ste 100
Dalton, GA 30720-8662

Phone

(706) 529-3072

Fax

(706) 529-3077

NPI assigned

Feb 26, 2021

Last updated

Sep 11, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Janae Alise Herzog Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Pi: Prevention and Intervention Wound Care and Dermatological Services

  • Nursing Care Agency
  • Tampa, FL
  • NPI 1396313110
  Medicare reassignment NPD
• Hamilton Physician Group Inc

  • Cardiovascular Disease Physician
  • Dalton, GA
  • NPI 1235455569
  NPD

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1760076053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 MEMORIAL DR STE 100",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307208662",
            "telephone_number": "706-529-3072",
            "fax_number": "706-529-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 MEMORIAL DR STE 100",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307208662",
            "telephone_number": "706-529-3072",
            "fax_number": "706-529-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JANAE",
        "middle_name": "ALISE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-26",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11011659",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "APRN-NP719288",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "GAA-NP004633",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANAE",
            "last_name": "HERZOG",
            "middle_name": "ALISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Billy Dai-Sung Chung, DDS
• John Y Chung, MD
• John Clayton Church, MD
• Brandy Lee Clark, APRN
• Crystal Lynn Clark, MS, ATC
• Jane S. Clark
• Jasmine Clark
• Jennifer Kathleen Clark, LCSW
• Krista Renae Clark, M.S. CCC-SLP
• Toby Johnson Clarkson, DMD

• Gerontology Nurse Practitioner in Dalton, GA
• Providers in Dalton, GA by specialty
• Gerontology Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.