Michelle Clarke, CPT , CNA

Primary specialty

EEG TechnicianTaxonomy code 2472E0500X

License

C9P4H9A3 Issued in GA

Practice address

4532 Browns Mill Ferry Rd
Lithonia, GA 30038-4528

Phone

(404) 437-3540

Fax

(404) 437-3540

NPI assigned

Jan 12, 2018

Last updated

Jan 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1184132177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4532 BROWNS MILL FERRY RD",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300384528",
            "telephone_number": "678-362-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4532 BROWNS MILL FERRY RD",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300384528",
            "telephone_number": "404-437-3540",
            "fax_number": "404-437-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "MICHELLE",
        "credential": "CPT , CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-12",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2472E0500X",
            "taxonomy_group": "",
            "desc": "Technician, Other, EEG",
            "state": "GA",
            "license": "C9P4H9A3",
            "primary": true
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "GA",
            "license": "CN0000001529",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Other Technician in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Other Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.