Edward Joseph Clark III, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

200101028 Issued in NC

Practice address

1705 S. Tarboro St
Wilson, NC 27893

Phone

(252) 399-8928

Fax

(252) 399-7313

NPI assigned

Dec 19, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

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

Diagnostic Radiology

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proscan NCH Imaging LLCGroup PAC ID 6103233051, 104 clinicians

Nchmd IncGroup PAC ID 9436139565, 503 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Naples Community Hospital Hospital, Naples, FL, CCN 100018
• Physicians Regional Medical Center - Pine Ridge Hospital, Naples, FL, CCN 100286
• Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score

91.03 of 100Reported as group

Quality

98.89

Improvement activities

40

Cost

72.14

Merit-based Incentive Payment System (MIPS)

Final score

95.25 of 100Reported as apm

Quality

87.73

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (6 of 8)

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Nchmd Inc

  • Hematology & Oncology Physician
  • Naples, FL
  • NPI 1831120195

  FL

  Medicare reassignment Care Compare group NPD
• Proscan NCH Imaging LLC

  • Diagnostic Radiology Physician
  • Naples, FL
  • NPI 1003406711

  Diagnostic Radiology, FL

  Medicare reassignment Care Compare group NPD
• Nchmd, Inc

  • Durable Medical Equipment & Medical Supplies
  • Naples, FL
  • NPI 1033904651
  Care Compare group NPD
• Nchmd, Inc

  • Durable Medical Equipment & Medical Supplies
  • Naples, FL
  • NPI 1477348092
  Care Compare group
• Mecklenburg Diagnostic Imaging LLC

  • Diagnostic Radiology Physician
  • Charlotte, NC
  • NPI 1093773384

  Diagnostic Radiology

  NPD
• Presbyterian Imaging Centers LLC

  • Diagnostic Radiology Physician
  • Charlotte, NC
  • NPI 1144477258

  Diagnostic Radiology

  NPD
• Wilson Radiology Inc

  • Radiologic Technologist
  • Rocky Mount, NC
  • NPI 1326251661
  NPD (past)

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

• Lee Health System Inc

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1427806025

  Hospital

  Care Compare affiliation
• Naples Community Hospital Inc

  • General Acute Care Hospital
  • Naples, FL
  • NPI 1720085137

  Hospital

  Care Compare affiliation
• Naples Hma LLC

  • General Acute Care Hospital
  • Naples, FL
  • NPI 1215003348

  Hospital

  Care Compare affiliation
• Naples Hma LLC

  • General Acute Care Hospital
  • Naples, FL
  • NPI 1316992134

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1053474080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12156",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236122156",
            "telephone_number": "757-867-6101",
            "fax_number": "757-867-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 S. TARBORO ST",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "27893",
            "telephone_number": "252-399-8928",
            "fax_number": "252-399-7313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "EDWARD",
        "middle_name": "JOSEPH",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NC",
            "license": "200101028",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "200101028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00129619",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891297G",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1297G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Michelle Childers, NP
• Heather M Christman
• Clarity Home Care Agency
• Clark-Blackmond & Associates LLC
• Anthony Jamal Clark
• John Philip Clarke, CPO
• Natalie Tamara Clarke, PMHNP
• Terry Claycomb, DPM
• Clearscreen, LLC
• Clement B Woodard DDS PA

• All providers in Wilson, NC
• Diagnostic Radiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.