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Ebonique Clark
NPI 1104247584 · Case Manager/Care Coordinator · Jackson, TN
Ebonique Clark is a Case Manager/Care Coordinator provider in Jackson, TN (NPI 1104247584).
Provider details
- NPI number
- 1104247584
- Entity type
- Individual
- Primary specialty
- Case Manager/Care CoordinatorOther Service Providers
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Profile Score
Established profile(70/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
238 Summar Dr
Jackson, TN 38301-3906
Phone: (731) 541-8200
Fax: (731) 660-8739
Street-level locationGet directions
Mailing address
1804 Highway 45 Byp
Jackson, TN 38305-4436
Registry dates
- Enumerated
- 2014-01-02
- Last updated
- 2014-01-02
Frequently asked questions
- What is Ebonique Clark's NPI number?
- Ebonique Clark's National Provider Identifier (NPI) is 1104247584, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Ebonique Clark's specialty?
- Ebonique Clark is listed in the NPPES registry with a primary specialty of Case Manager/Care Coordinator (Other Service Providers).
- Where is Ebonique Clark located?
- Ebonique Clark's practice location on file with NPPES is 238 Summar Dr, Jackson, TN 38301-3906.
- What is Ebonique Clark's phone number?
- The practice phone number listed in the NPPES registry for Ebonique Clark is (731) 541-8200.
- Is Ebonique Clark's NPI active?
- Yes — Ebonique Clark's NPI (1104247584) is active in the NPPES registry as of the last update on 2014-01-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.