Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mark D Clark, FNP

Individual provider Nurse Practitioner · NPI 1285631887

Mark D Clark, FNP is a Nurse Practitioner in Gainesville, Georgia. Qualified in 2001, 25 years ago. Practices with Northeast Georgia Diagnostic Associates and Clinic, LLC, a 81-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
25
Licensed in
GA
In the registry since
2005
Specialties on file
4
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

102 Barrett St
Gainesville, GA 30501-1356
Phone: (770) 540-4274
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1240 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3862 — (770) 536-9864

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence RN128712 (GA)
Nurse Practitioner Taxonomy 363L00000X · Licence RN128712 (GA)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence RN128712 (GA)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence RN128712 (GA)

Record details

NPI number1285631887
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP
Sole proprietorNo
NPI enumeratedJune 29, 2005
Last updated in NPPESFebruary 5, 2021
Certification dateFebruary 5, 2021
Mailing address102 Barrett St, Gainesville, GA 30501-1356

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Northeast Georgia Diagnostic Associates And Clinic, Llc — 81 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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