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

Mrs. Shantera Clark, FNP-C

Individual provider Family Nurse Practitioner · NPI 1962020057

Mrs. Shantera Clark, FNP-C is a Nurse Practitioner in Statesboro, Georgia. Qualified in 2019, 7 years ago. Practices with Privia Medical Group of Georgia LLC, a 450-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
7
Licensed in
GA
In the registry since
2020
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

630 Ogeechee Dr W
Statesboro, GA 30461-6753
Phone: (478) 456-0238
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN220889 (GA)

Record details

NPI number1962020057
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedJuly 6, 2020
Last updated in NPPESAugust 4, 2022
Certification dateAugust 4, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Privia Medical Group Of Georgia Llc — 450 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Statesboro