Courtney Clark, DO
NPI 1790100113 · Pediatrics Physician · Picayune, MS
Enrolled with Medicare as Practitioner - Pediatric Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Courtney Clark, DO is a Pediatrics Physician provider in Picayune, MS (NPI 1790100113).
Provider details
- NPI number
- 1790100113
- Entity type
- Individual
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Female
- Sole proprietor
- Yes
- License
- 1790100113 (VA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure33% of score
12 yrs in NPPES registry
- Profile completeness33% of score
100% of core fields populated
- Practice footprint20% of score
2 documented practice locations
- Open Payments transparency13% of score
Has Open Payments disclosures (2024)
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.
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$23 across 1 record (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Additional practice locations (1)
- 554 Keily StreetJacksonville, FL 32212Phone: (757) 953-7550Fax: (757) 953-7560
Registry dates
- Enumerated
- 2014-02-21
- Last updated
- 2021-11-15
- Certified
- 2021-11-15
Frequently asked questions
- What is Courtney Clark's NPI number?
- Courtney Clark's National Provider Identifier (NPI) is 1790100113, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Courtney Clark's specialty?
- Courtney Clark is listed in the NPPES registry with a primary specialty of Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Courtney Clark located?
- Courtney Clark's practice location on file with NPPES is 2274 Highway 43 S, Picayune, MS 39466-8141.
- What is Courtney Clark's phone number?
- The practice phone number listed in the NPPES registry for Courtney Clark is (601) 347-9024.
- Does Courtney Clark accept Medicare?
- Courtney Clark is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Courtney Clark's NPI active?
- Yes — Courtney Clark's NPI (1790100113) is active in the NPPES registry as of the last update on 2021-11-15.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.