Stephanie Lynn Clark, PA-C

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

2384 Issued in AL

Practice address

808 Madison Street SE
Huntsville, AL 35801

Phone

(256) 256-1000

NPI assigned

Apr 17, 2024

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 AL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Emergency Physicians Group

  • Emergency Medicine Physician
  • Huntsville, AL
  • NPI 1659366649
  Medicare reassignment

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1184479834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 HIDDEN BRANCH RD",
            "city": "OWENS CROSS ROADS",
            "state": "AL",
            "postal_code": "357635609",
            "telephone_number": "256-655-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 MADISON STREET SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "35801",
            "telephone_number": "256-256-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "AL",
            "license": "2384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph W Clark, MD
• Kendall Jayne Jordan Clark, MS, CCC-SLP
• Misty Roberts Clark
• Rachel Clark, BCBA
• Robert Jamie Clark, M.D.
• Stephen Forest Clark, M.D.
• Taylor Clark, PA-C
• David Clarke, CPED
• Emily Hope Clawson, CRNP
• Chelsea Walker Clay

• Emergency Medical Services (Emergency Medicine) Physician in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.