Jacquelyn Sue Grace Clark, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E-19213 Issued in AR

Practice address

909 Unity Rd
Crossett, AR 71635-9444

Phone

(870) 364-9111

NPI assigned

Mar 24, 2022

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 AR

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

Family Practice

Education

New York College of Osteo Medicine of New York Institute of Technology, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crossett Health FoundationGroup PAC ID 9133030117, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Acmc Family Home Health Home health agency, Crossett, AR, CCN 047109
• Ashley County Medical Center Hospital, Crossett, AR, CCN 041323
• Ashley County Medical Center Nursing home, CCN 04Z323

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Crossett Health Foundation

  • Critical Access Hospital
  • Crossett, AR
  • NPI 1952308215
  Medicare reassignment Care Compare group NPD
• Crossett Health Foundation

  • Rural Health Clinic/Center
  • Crossett, AR
  • NPI 1639159973
  NPD
• Crossett Health Foundation

  • Pediatric Otolaryngology Physician
  • Crossett, AR
  • NPI 1548252745
  NPD (past)
• Crossett Health Foundation

  • Medicare Defined Swing Bed Hospital Unit
  • Crossett, AR
  • NPI 1649443144
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Arkansas Homecare of Forrest City, LLC

  • Home Health Agency
  • Crossett, AR
  • NPI 1821661299
  Care Compare affiliation
• Crossett Health Foundation

  • Medicare Defined Swing Bed Hospital Unit
  • Crossett, AR
  • NPI 1649443144

  Nursing home

  Care Compare affiliation
• Crossett Health Foundation

  • Critical Access Hospital
  • Crossett, AR
  • NPI 1952308215
  Care Compare affiliation

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1780334656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 UNITY RD",
            "city": "CROSSETT",
            "state": "AR",
            "postal_code": "716359444",
            "telephone_number": "870-364-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 UNITY RD",
            "city": "CROSSETT",
            "state": "AR",
            "postal_code": "716359444",
            "telephone_number": "870-364-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JACQUELYN",
        "middle_name": "SUE GRACE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-19213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Sue Cathey
• Child'S Play Therapy Services of Arkansas, PLLC
• Hannah Christmas
• City of Crossett
• City Rexall Drug Pharmacy
• Community Compassion Stonegate
• Complete Integrated Healthcare LLC
• Continuum, LLC
• Ledelma Asariaz Cotoco, OTR
• Crossett Health Foundation

• Family Medicine Physician in Crossett, AR
• Providers in Crossett, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; 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.