MRS. GRACE CLARK (AGPCNP-B) – Adult Health Nurse Practitioner, NPI 1780030734
Adult 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 MRS. GRACE CLARK (AGPCNP-B)
3825 MEDICAL PARK DR
SUITE 100
AUSTELL, GA 301066831
Phone: (770) 948-5578
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 104 Open Payments records for all available years, with a total value of $2,073.
Total Amount is formed as General ($2,073) + Research ($0) + Ownership ($0) = $2,073.
Last reported payment date: 2024-12-23 • Largest payer in this snapshot: Novo Nordisk Inc ($338).
Total Amount
$2,073
General + Research + Ownership
Payments
104
Total payment records
General Amount
$2,073
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $338 |
| Abbott Laboratories | $164 |
| Dexcom, Inc. | $149 |
| Amgen Inc. | $115 |
| Lilly USA, LLC | $97 |
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: 2016-07-28
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 |
|---|---|---|---|---|
| I20160728001192 | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 247 | 171 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 66 | 56 | $0 |
| 95251 | Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report | 44 | 29 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 37 | 32 | $0 |
| 82962 | Blood glucose (sugar) test performed by hand-held instrument | 19 | 16 | $0 |
Insurance plans in this area (ZIP 30106)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | GA | 83036 | Hemoglobin A1C level | 20 | 20 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | GA | |
| - | GA | |
| - | GA | |
| R H E U M A T O L O G Y | MI | |
| Hospitalist, Internal Medicine | GA | |
| Nurse Practitioner | TN | |
| Family Practice | GA | |
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| Hospitalist, Internal Medicine | GA |
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