Justin Clack, PA
Justin Clack, PA is a Physician Assistant in Athens, GA, registered under NPI 1750634754. This provider registers 4 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 242 KING AVE STE 130, Athens, GA 30606. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 6639 | GA | Pulmonary Disease Physician |
| 6639 | GA | Orthopaedic Surgery Physician |
| 6639 | GA | Orthopaedic Trauma Physician |
This provider holds licence 6639 issued in GA. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Practitioner - Physician Assistant
- PAC ID
- 5597918300
- Enrollment ID
- I20130103000251
Medicare enrolment is recorded as approved under the provider type Practitioner - Physician Assistant. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Physician Assistant covers
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. NUCC Health Care Provider Taxonomy, code 363A00000X
All registered taxonomy codes
This provider registers 4 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207RP1001X | Pulmonary Disease Physician Pulmonary Disease | 6639 | GA | |
| 207X00000X | Orthopaedic Surgery Physician | 6639 | GA | |
| 207XX0801X | Orthopaedic Trauma Physician Orthopaedic Trauma | 6639 | GA | |
| 363A00000X | Physician Assistant | — | — | primary |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1750634754 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Oct 16, 2012 |
| Last updated | Mar 29, 2024 |
| Status | Active |
| Sole proprietor | Yes |
| Gender | Male |
| Credential | PA |
| Practice address |
242 KING AVE STE 130 Athens, GA 30606 (706) 613-5880 |
| Mailing address |
550 PEACHTREE STREET DAVIS FISCHER BUILDING OFFICE 330 Atlanta, GA 30308 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 7 | 5 | 0 | 6 | 3 | 4 | 7 | 5 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 7 | 1 | 0 | 3 | 3 | 8 | 7 | 1 |
Sum = 56 · next multiple of 10 = 60 · check digit = 4 · actual last digit = 4
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.