Individual provider Active NPI

Suzanne Dimple Clarke, M.D.

  • Family Medicine Physician
  • Atlanta, GA
National Provider Identifier
1063470896
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
057446 Issued in GA
Practice address
1263 Moreland Ave SE
Atlanta, GA 30316-3183
Phone
(470) 444-3137
Fax
(470) 202-3003
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 057446 GA Primary

Addresses

Primary practice location

1263 Moreland Ave SE
Atlanta, GA 30316-3183

Mailing address

PO Box 740015
Atlanta, GA 30374-0015
Phone (312) 733-9730

Other practice location 1

2732 Candler Rd
Decatur, GA 30034-1410
Phone (470) 444-3133

Other practice location 2

1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (912) 435-6979

Other practice location 3

3088 Washington Rd
East Point, GA 30344-4566
Phone (470) 444-3135

Other practice location 4

1825 Rockbridge Rd Ste 15B
Stone Mountain, GA 30087-3306
Phone (470) 444-3134

Other practice location 5

7028 Highway 85
Riverdale, GA 30274-2946
Phone (470) 444-3136

Other practice location 6

1631 Gordon Hwy Ste 17A
Augusta, GA 30906-2229
Phone (706) 261-0018

Other practice location 7

625 S Marietta Pkwy SE
Marietta, GA 30060-2748
Phone (470) 377-7228

Other practice location 8

677 Cascade Ave SW
Atlanta, GA 30310-2404
Phone (470) 444-3143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20060525000200 GA Practitioner - Family Practice 9830150390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6000 Hillandale Dr
Suite 100
Lithonia, GA 30058-4860
Phone (678) 418-2120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
057446GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services,LLC Family Medicine Current Accepting new patients
Northside Primary Care Professional Services, LLC CurrentSince Mar 1, 2025 Accepting new patients
Qcpi-Villagemd, PC Family Medicine Past Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Effingham Hospital, Inc. PastSince Jun 8, 2025 Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Johnson Regional Medical Center Past Accepting new patients
Professional Resource Management of Wiregrass, LLC Past Accepting new patients

Locations

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/1a399bfe-f78b-4bd3-b22b-301d9fc9736a/

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1063470896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740015",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740015",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 MORELAND AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303163183",
            "telephone_number": "470-444-3137",
            "fax_number": "470-202-3003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2732 Candler Rd",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300341410",
            "country_code": "US",
            "telephone_number": "470-444-3133",
            "fax_number": "470-276-4051",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1061 Harmon Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Stewart",
            "state": "GA",
            "postal_code": "313145641",
            "country_code": "US",
            "telephone_number": "912-435-6979",
            "fax_number": "912-435-6706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3088 Washington Rd",
            "address_purpose": "LOCATION",
            "city": "East Point",
            "state": "GA",
            "postal_code": "303444566",
            "country_code": "US",
            "telephone_number": "470-444-3135",
            "fax_number": "404-777-9336",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1825 Rockbridge Rd Ste 15B",
            "address_purpose": "LOCATION",
            "city": "Stone Mountain",
            "state": "GA",
            "postal_code": "300873306",
            "country_code": "US",
            "telephone_number": "470-444-3134",
            "fax_number": "470-276-4370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7028 Highway 85",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "GA",
            "postal_code": "302742946",
            "country_code": "US",
            "telephone_number": "470-444-3136",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1631 Gordon Hwy Ste 17A",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309062229",
            "country_code": "US",
            "telephone_number": "706-261-0018",
            "fax_number": "762-257-7442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "625 S Marietta Pkwy SE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300602748",
            "country_code": "US",
            "telephone_number": "470-377-7228",
            "fax_number": "470-467-7583",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "677 Cascade Ave SW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303102404",
            "country_code": "US",
            "telephone_number": "470-444-3143",
            "fax_number": "470-467-7469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "SUZANNE",
        "middle_name": "DIMPLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "057446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.