Individual provider Active NPI

Steven Alan Clark, DC

  • Chiropractor
  • Rocky Mount, NC
National Provider Identifier
1124036058
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3396 Issued in NC
Practice address
2747 Sunset Ave
Rocky Mount, NC 27804-3751
Phone
(252) 446-8800
Fax
(252) 446-0080
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3396 NC Primary

Addresses

Primary practice location

2747 Sunset Ave
Rocky Mount, NC 27804-3751

Mailing address

PO Box 7067
Rocky Mount, NC 27804-0067
Phone (252) 446-8800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070112000111 NC Practitioner - Chiropractic 0749235158 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Miller Chiropractic of Rocky Mount, PCGroup PAC ID 4789745985, 2 clinicians

Practice addresses (Care Compare)

2747 Sunset Ave
Suite 107
Rocky Mount, NC 27804-3751
Phone (252) 446-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3396NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Miller Chiropractic of Rocky Mount, PC Chiropractor CurrentSince Oct 20, 2008 Accepting new patients
Edgecombe Chiropractic Inc Chiropractor CurrentSince Apr 22, 2025 Accepting new patients
Sleep Associates of East Tennessee PLLC Past Accepting new patients

Locations

2747 Sunset Ave
Rocky Mount, NC 27804
Phone (252) 446-8800

2747 Sunset Ave
#107
Rocky Mount, NC 27804
Phone (252) 446-8800

224 N Fairview Rd
Rocky Mount, NC 27801
Phone (252) 446-7246

Organizations & group practices 3

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1124036058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7067",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278040067",
            "telephone_number": "252-446-8800",
            "fax_number": "252-446-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2747 SUNSET AVE",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278043751",
            "telephone_number": "252-446-8800",
            "fax_number": "252-446-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "STEVEN",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.