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

Mary Olivia Clark, PA

Individual provider Medical Physician Assistant · NPI 1821541152

Mary Olivia Clark, PA is a Physician Assistant in Athens, Georgia. Qualified in 2016, 10 years ago. Practices with St Mary's Medical Group, Inc, a 118-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
10
Licensed in
GA
In the registry since
2016
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2142 W Broad St Bldg 100 Ste 200
Athens, GA 30606-3509
Phone: (706) 548-6881
Fax: (706) 546-0821
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 8057 (GA)

Record details

NPI number1821541152
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 3, 2016
Last updated in NPPESMarch 4, 2026
Certification dateMarch 4, 2026
Mailing addressPo Box 48089, Athens, GA 30604-8089

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice St. Mary'S Medical Group, Inc. — 118 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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