Joseph M Clark, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

9700217 Issued in NC

Practice address

1248 Huffman Mill Rd
Ste 201
Burlington, NC 27215-8700

Phone

(336) 538-1966

Fax

(336) 538-1729

NPI assigned

Oct 3, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

OtolaryngologyAlso: Plastic and Reconstructive Surgery

Education

Wake Forest University School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of North Carolina at Chapel HillGroup PAC ID 0648181156, 2,028 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unc Hospitals Hospital, Chapel Hill, NC, CCN 340061

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jclark110107@direct.unc.nchie.net

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

• University of North Carolina at Chapel Hill

  • Anesthesiology Physician
  • Chapel Hill, NC
  • NPI 1780669200

  Otolaryngology

  Medicare reassignment Care Compare group NPD
• Chatham Hospital, Inc.

  • Critical Access Hospital
  • Siler City, NC
  • NPI 1689967457
  Medicare reassignment NPD
• Park Ophthalmology

  • Ophthalmology Physician
  • Durham, NC
  • NPI 1619150141
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University of North Carolina Hospitals at Chapel Hill

  • General Acute Care Hospital
  • Chapel Hill, NC
  • NPI 1932208576
  Care Compare affiliation

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1053308288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24848",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271144848",
            "telephone_number": "336-538-1966",
            "fax_number": "336-538-1729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1248 HUFFMAN MILL RD",
            "address_2": "STE 201",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158700",
            "telephone_number": "336-538-1966",
            "fax_number": "336-538-1729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JOSEPH",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "NC",
            "license": "9700217",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "9700217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jclark110107@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1031 Pinehurst Dr",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275175664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patricia Wagoner Clapp, RN, ANP-C
• Amanda Myers Clark, CNM
• Heaven Clark, MS, OTR/L
• Jerry Kent Clark Jr.
• Jessica C Clark, PA-C
• Meghan Rosilae Clark, PA-C
• Temesha Clark
• Kathy Clayton, MSW, LCSW
• Clegail Professional Services LLC
• Bridgette Clifton, AGNP-C

• Otolaryngology Physician in Burlington, NC
• Providers in Burlington, NC by specialty
• Otolaryngology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.