Ross Jameson Clark, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN217210 Issued in GA

Practice address

2738 N Decatur Rd
Decatur, GA 30033-5910

Phone

(404) 508-8058

NPI assigned

Aug 8, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

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 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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

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.

• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790200087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2738 N DECATUR RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335910",
            "telephone_number": "404-508-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2738 N DECATUR RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335910",
            "telephone_number": "404-508-8058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Owens Springs Ln",
            "address_purpose": "LOCATION",
            "city": "McDonough",
            "state": "GA",
            "postal_code": "302524545",
            "country_code": "US",
            "telephone_number": "678-549-8948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "670 S 8th St",
            "address_purpose": "LOCATION",
            "city": "Griffin",
            "state": "GA",
            "postal_code": "302244214",
            "country_code": "US",
            "telephone_number": "770-233-3444",
            "fax_number": "770-233-9400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ROSS",
        "middle_name": "JAMESON",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-08",
        "last_updated": "2022-07-21",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN217210",
            "primary": true
        },
        {
            "code": "163WX0800X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Orthopedic",
            "state": "GA",
            "license": "RN217210",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Clark, MSW
• Mary Katherine Clark, PA-C
• Neal Clark, ARRT
• Omeka Clark, PHARM.D.
• Owen Clark
• Sharronda Renee Clark, FNP
• Tamika Tashell Clark, LPC
• Alexis Clarke, BACHELOR OF SCIENCE
• Sakinah Clarke
• Clear Vision Eye Center

• Family Nurse Practitioner in Decatur, GA
• Providers in Decatur, 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 Jul 21, 2022; 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.