George L Clark, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0264 Issued in SC

Practice address

8740 Rivers Ave
North Charleston, SC 29406-9211

Phone

(843) 572-5990

Fax

(843) 572-2928

NPI assigned

Jul 5, 2005

Last updated

Mar 10, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Midwestern University, Chicago College of Osteopathic Med, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medcare Express - North Charleston LLCGroup PAC ID 7618074899, 69 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medcare Express - North Charleston LLC

  dba Medcare Urgent Care

  • Urgent Care Clinic/Center
  • Charleston, SC
  • NPI 1457579617
  Medicare reassignment Care Compare group NPD
• Medcare Urgent Care Center - Anderson LLC

  • Urgent Care Clinic/Center
  • Anderson, SC
  • NPI 1689004095
  NPD
• Charleston Carenow Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Goose Creek, SC
  • NPI 1093248288
  NPD (past)
• Robertson Emergency Physicians

  • Emergency Medicine Physician
  • Walterboro, SC
  • NPI 1013066752
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1013914126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8740 RIVERS AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069211",
            "telephone_number": "843-572-5990",
            "fax_number": "843-572-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8740 RIVERS AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069211",
            "telephone_number": "843-572-5990",
            "fax_number": "843-572-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "GEORGE",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "0264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002641",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Ciocci, MS, CCC-SLP
• Civic Medication Management Services LLC
• Tyson Lee Claiborne
• Calli Layne Clark, DMD
• Chloe Clark, PT, DPT
• Janet Kay Clark, RN
• Shelley L Clayton, P.T
• Clemson Sports Medicine and Rehabilitation (Sports Plus)
• Clemson Sports Medicine and Rehabilitation, Inc (Sports Plus)
• Clemson Sports Medicine and Rehabilitation, Inc. (Balance Dizziness & Mobility Center)

• Family Medicine Physician in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.