Individual provider Active NPI

Julie Theriot Clark, RN

  • Hospice Registered Nurse
  • Simpsonville, SC
National Provider Identifier
1184542128
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice Registered NurseTaxonomy code 163WH1000X
License
75989 Issued in SC
Practice address
634A Fairview Rd
Simpsonville, SC 29680-6707
Phone
(864) 884-0202
NPI assigned
Jul 8, 2026
Last updated
Jul 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice Registered Nurse 163WH1000X 75989 SC Primary

Addresses

Primary practice location

634A Fairview Rd
Simpsonville, SC 29680-6707

Mailing address

220 Edgewood Dr
Mauldin, SC 29662-1908
Phone (864) 884-0202

Other practice location 1

615 Green St NW
Gainesville, GA 30501-3378
Phone (864) 628-2273

Other practice location 2

500 Lakeshore Pkwy
Rock Hill, SC 29730-4273
Phone (803) 818-6900

Other practice location 3

704A Breedlove Dr
Monroe, GA 30655-2054
Phone (470) 816-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1783468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1184542128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 EDGEWOOD DR",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296621908",
            "telephone_number": "864-884-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634A FAIRVIEW RD",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296806707",
            "telephone_number": "864-884-0202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 Green St NW",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013378",
            "country_code": "US",
            "telephone_number": "864-628-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Lakeshore Pkwy",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297304273",
            "country_code": "US",
            "telephone_number": "803-818-6900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "704A Breedlove Dr",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "GA",
            "postal_code": "306552054",
            "country_code": "US",
            "telephone_number": "470-816-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JULIE",
        "middle_name": "THERIOT",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-08",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "SC",
            "license": "75989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; 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.