Shaquenciana Clark
NPI 1265160584ActiveIndividual· Student in an Organized Health Care Education/Training Program· Douglasville, GA
Student in an Organized Health Care Education/Training Program in Douglasville, Georgia, with an NPI issued in August 2022. Enrolled in Medicare as order and referring only - family practice.
Overview
| NPI | 1265160584 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Aug 13, 2022 |
| Last updated in NPPES | Apr 21, 2026 |
| Certified by provider | Apr 21, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Order and Referring Only - Family Practice (GA) |
|---|
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All 22 Student in an Organized Health Care Education/Training Program providers in Douglasville · All Student in an Organized Health Care Education/Training Program providers in Georgia