Christopher Jerome Clark, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

2017-02091 Issued in NC

Practice address

2704 Henry St
Greensboro, NC 27405-3633

Phone

(336) 663-5700

Fax

(336) 663-5734

NPI assigned

May 31, 2012

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

Medicare fee-for-service enrollment

Enrolled in NC

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

Vascular Surgery

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Moses H Cone Memorial Hospital Operating CorporationGroup PAC ID 6204744600, 724 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adoration Home Health Home health agency, High Point, NC, CCN 347125
• Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• The Moses H. Cone Memorial Hospital Operating Corporation

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1013265909
  Medicare reassignment Care Compare group NPD
• The Moses H Cone Memorial Hospital Operating Corporation

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1356372064
  NPD
• The Moses H Cone Memorial Hospital Operating Corporation

  • Community/Retail Pharmacy
  • Eden, NC
  • NPI 1861222507
  NPD
• The Moses H. Cone Memorial Hospital Operating Corporation

  • Maternal & Fetal Medicine Physician
  • Greensboro, NC
  • NPI 1891351847
  NPD (past)

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

• Adoration Home Health Care Virginia LLC

  • Home Health Agency
  • High Point, NC
  • NPI 1164499562
  Care Compare affiliation
• The Moses H. Cone Memorial Hospital Operating Corporation

  • General Acute Care Hospital
  • Greensboro, NC
  • NPI 1477591055
  Care Compare affiliation

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1134480668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 HENRY ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274053633",
            "telephone_number": "336-663-5700",
            "fax_number": "336-663-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 HENRY ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274053633",
            "telephone_number": "336-663-5700",
            "fax_number": "336-663-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHRISTOPHER",
        "middle_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-31",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "2017-02091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clark Chiropractic Offices
• Jennifer R Clark-Bruning, PAC
• Alan R Clark, PA-C
• Ashley Clark, ITFS
• Cheryl Clark, FNP
• David Charles Clark Jr., MD
• Dyanna Geffel Clark, M.D.
• Gilbert W Clark, PA-C
• Holly Ann Clark, CADC
• Jaylah Clark

• Vascular Surgery Physician in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Vascular Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.