MARK D CLARK FNP NPI 1285631887

NPI Information

  • NPI: 1285631887
  • Provider Name: MARK D CLARK, FNP
  • Classification: Nurse Practitioner - 363LA2100X
  • Specialization: Acute Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 102 BARRETT ST
    GAINESVILLE, GA
    ZIP 30501
  • Phone: (770) 540-4274

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NPI Details

Mark D Clark, FNP is an acute care nurse practitioner in Gainesville, GA with 24 years of experience. Mark D Clark, FNP NPI is 1285631887. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

102 BARRETT ST
GAINESVILLE, GA
ZIP 30501-356
Phone: (770) 540-4274

The NPI 1285631887 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)

The enumeration date for this NPI number is 6/29/2005 and was last updated on 2/5/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse PractitionerRN128712GEORGIANo
2363LA2200XNurse PractitionerAdult HealthRN128712GEORGIANo
3363LG0600XNurse PractitionerGerontologyRN128712GEORGIANo
4363LA2100XNurse PractitionerAcute CareRN128712GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11738523OTHERGEORGIAWELLCARE
2615230572DMEDICAIDGEORGIA
3615230572FMEDICAIDGEORGIA
406423272OTHERGEORGIAAMERIGROUP
5615230572CMEDICAIDGEORGIA
6615230572EMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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