NA'Zae Athena Clark, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110009412 Issued in VA

Practice address

680 Oyster Point Rd Ste 200
Newport News, VA 23606-4570

Phone

(757) 668-4851

NPI assigned

Dec 9, 2022

Last updated

Oct 23, 2023By the provider in NPPES

Sex

Female

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 VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Eastern Virginia Medical School, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Childrens Hospital of the Kings Daughters Inc

  dba CHKD Urgent Care

  • Urgent Care Clinic/Center
  • Chesapeake, VA
  • NPI 1578954590
  Medicare reassignment

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1174234223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 OYSTER POINT RD STE 200",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064570",
            "telephone_number": "757-668-4851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 OYSTER POINT RD STE 200",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064570",
            "telephone_number": "757-668-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "NA'ZAE",
        "middle_name": "ATHENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110009412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cariana Josephine Clanton, DO
• Anna Irene Clark, MD
• Dana Maria Clark, PA-C
• Donna Patricia Clark, NURSE PRACTITIONER
• Matthew Mitchell Clark, DMD
• Sarah Clark, MOT
• Theresa Hitselberger Clark, MD
• Thomas W Clark, M.S., M.D., F.A.C.S.
• Tyler S Clark, DPT
• Crystal Clary, LPC

• Medical Physician Assistant in Newport News, VA
• Providers in Newport News, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.