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

Nicole M Clark, PA-C

Individual provider Physician Assistant · NPI 1114164142

Nicole M Clark, PA-C is a Physician Assistant in Saluda, South Carolina. Qualified in 2008, 18 years ago. Practices with Self Medical Group, a 396-clinician group and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
18
Licensed in
SC
In the registry since
2009
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

595 Newberry Hwy
Saluda, SC 29138-7808
Phone: (864) 445-2500
Fax: (864) 445-3956
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2017 (SC)

Record details

NPI number1114164142
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 13, 2009
Last updated in NPPESDecember 21, 2021
Certification dateDecember 21, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Self Medical Group — 396 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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