Susan Christine Clark, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

0101253279 Issued in VA

Practice address

Naval Medical Center Portsmouth
620 John Paul Jones Circle
Portsmouth, VA 23708

Phone

(757) 953-9759

Fax

(757) 953-0845

NPI assigned

Mar 11, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA, ME2 enrollments

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 2

Specialty

General Surgery

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chesapeake Regional Medical GroupGroup PAC ID 8426113663, 148 clinicians

MRH CorpGroup PAC ID 1355770892, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northern Light Mayo Hospital Hospital, Dover Foxcroft, ME, CCN 201309
• Chesapeake General Hospital Hospital, Chesapeake, VA, CCN 490120
• Glendive Medical Center Hospital, Glendive, MT, CCN 271332

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 and National Provider Directory roles.

• Chesapeake Regional Medical Group

  • Surgery Physician
  • Chesapeake, VA
  • NPI 1699940270
  Medicare reassignment Care Compare group NPD
• MRH Corp.

  • Critical Access Hospital
  • Dover Foxcroft, ME
  • NPI 1558319103
  Medicare reassignment Care Compare group NPD
• Bon Secours Medical Group Hampton Roads Specialty Care LLC

  • Cardiovascular Disease Physician
  • Richmond, VA
  • NPI 1629637475

  Surgery

  Medicare reassignment NPD
• Bon Secours Medical Group Hampton Roads Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Franklin, VA
  • NPI 1205451028
  NPD
• Chesapeake Regional Medical Group

  • Urgent Care Clinic/Center
  • Chesapeake, VA
  • NPI 1255215133
  NPD
• Mary Immaculate Hospital

  • Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
  • Newport News, VA
  • NPI 1194267229
  NPD
• Mary Immaculate Hospital LLC

  • General Acute Care Hospital
  • Newport News, VA
  • NPI 1538535463
  NPD
• MRH Corp.

  • Medicare Defined Swing Bed Hospital Unit
  • Dover Foxcroft, ME
  • NPI 1548463623
  NPD
• East Carolina University

  • Internal Medicine Physician
  • Greenville, NC
  • NPI 1366491185
  NPD (past)
• East Carolina University

  • Obstetrics & Gynecology Physician
  • Greenville, NC
  • NPI 1528016938
  NPD (past)

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

• Chesapeake Hospital Authority

  • General Acute Care Hospital
  • Virginia Beach, VA
  • NPI 1003265075
  Care Compare affiliation
• Chesapeake Hospital Authority

  • Pharmacy
  • Chesapeake, VA
  • NPI 1558466318

  Hospital

  Care Compare affiliation
• Chesapeake Hospital Authority

  • General Acute Care Hospital
  • Chesapeake, VA
  • NPI 1700896354
  Care Compare affiliation
• Glendive Medical Center, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Glendive, MT
  • NPI 1073523635
  Care Compare affiliation
• Glendive Medical Center, Inc

  • Critical Access Hospital
  • Glendive, MT
  • NPI 1376552893
  Care Compare affiliation
• MRH Corp.

  • Critical Access Hospital
  • Dover Foxcroft, ME
  • NPI 1558319103
  Care Compare affiliation

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1104096650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CENTER PORTSMOUTH",
            "address_2": "620 JOHN PAUL JONES CIRCLE",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237089971",
            "telephone_number": "757-953-9759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CENTER PORTSMOUTH",
            "address_2": "620 JOHN PAUL JONES CIRCLE",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "23708",
            "telephone_number": "757-953-9759",
            "fax_number": "757-953-0845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SUSAN",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-11",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2011-00718",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD426779",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101253279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5918139",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "163WH",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ahlta/JLV",
            "affiliation": "N",
            "endpointDescription": "medical record uploading",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "NMRTC Portsmouth",
            "address_2": "620 John Paul Jones Circle",
            "city": "Portsmouth",
            "state": "VA",
            "country_code": "US",
            "postal_code": "23708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephanie Colleen Clapper, R.D.
• Clare Medical Inc
• Clark Quality Care LLC
• Courtney Morgan Clark, LCSW
• Matilda Anne Clark, RPH.
• Troy Clark, DO
• Vincent Jerome Clark, D.M.D.
• Zachariah Scott Class
• Julia Clayton, PSY.D.
• Roderick Lyle Clayton, PHYSICAL THERAPIST

• Surgery Physician in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.