JESSICA KATE CLARK (APRN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1417412917
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,652 NURSE PRACTITIONER in GA
Provider Addresses for JESSICA KATE CLARK (APRN)
3455 Harris Rd
Waycross, GA 315038960
Phone: (800) 342-8168
Type: Location
1007, Mary Street, Waycross, Ware County, Georgia, 31503, United States
WAYCROSS, GA 315033823
Phone: (800) 342-8168
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $93.
Total Amount is formed as General ($93) + Research ($0) + Ownership ($0) = $93.
Last reported payment date: 2024-04-16 • Largest payer in this snapshot: Alkermes, Inc. ($40).
Total Amount
$93
General + Research + Ownership
Payments
4
Total payment records
General Amount
$93
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alkermes, Inc. | $40 |
| Neurocrine BioSciences, Inc. | $28 |
| Neurocrine BioSciences Inc. | $25 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-05-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190514003111 | I | Nurse Practitioner | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 44 | 25 | $0 |
| 90792 | Psychiatric diagnostic evaluation with medical services | 17 | 16 | $0 |
| Q3014 | Telehealth originating site facility fee | 13 | 12 | $0 |
Insurance plans in this area (ZIP 31503)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | GA | |
| Mental Health Counselor | GA | |
| Nurse Practitioner | GA | |
| Mental Health Counselor | SC | |
| - | GA | |
| Nurse Practitioner | GA | |
| Clinical Social Worker | GA | |
| - | GA | |
| Mental Health Counselor | GA | |
| Mental Health Counselor | GA |
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