Matthew Taylor Clark, M.D.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

057156 Issued in GA

Practice address

616 Edgefield Rd
Suite 180
North Augusta, SC 29841-1938

Phone

(803) 279-7666

Fax

(803) 279-0708

NPI assigned

Apr 6, 2007

Last updated

Jul 29, 2020By 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

Allergy/Immunology

Education

Medical College of Georgia School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aiken Regional Medical Center Hospital, Aiken, SC, CCN 420082

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Covenant Family Allergy, PC

  • Allergy & Immunology Physician
  • North Augusta, SC
  • NPI 1205002888
  Medicare reassignment NPD Authorized official

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

• Aiken Regional Medical Centers LLC

  dba Wound Care Center

  • General Acute Care Hospital
  • Aiken, SC
  • NPI 1447437157
  Care Compare affiliation
• Aiken Regional Medical Centers LLC

  dba Aiken Regional Medical Center

  • General Acute Care Hospital
  • Aiken, SC
  • NPI 1467448498
  Care Compare affiliation
• Aiken Regional Medical Centers, LLC.

  dba Aiken Regional Medical Centers Neuro Physician Services

  • Neurological Surgery Physician
  • Aiken, SC
  • NPI 1942610928

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1053433250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 ALLEN CT",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298609782",
            "telephone_number": "803-279-7666",
            "fax_number": "803-279-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 EDGEFIELD RD",
            "address_2": "SUITE 180",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298411938",
            "telephone_number": "803-279-7666",
            "fax_number": "803-279-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MATTHEW",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "GA",
            "license": "057156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053433250",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marina Joanne Clements, DPT
• Jurell Coach
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• Melanie Norton Cochran, M.P.T
• Jessica Collins, MA-CCC

• Allergy & Immunology Physician in North Augusta, SC
• Providers in North Augusta, SC by specialty
• Allergy & Immunology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.