Michael Scott Clark, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35611 Issued in NC

Practice address

13815 Professional Center Dr Ste 100
Huntersville, NC 28078-7951

Phone

(704) 384-1320

NPI assigned

Dec 13, 2006

Last updated

Oct 27, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Psychiatry

Education

Texas a & M University System, HSC, College of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mclark423797@direct.novanthealth.org

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.

• Novant Health Medical Group, LLC

  dba Novant Health Endocrinology

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1306950282
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• The Presbyterian Hospital

  dba Novant Health Senior Care

  • Geriatric Medicine (Internal Medicine) Physician
  • Charlotte, NC
  • NPI 1053365817
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  dba Novant Health Orthopedics & Sports Medicine

  • Orthopaedic Surgery Physician
  • Cornelius, NC
  • NPI 1215179296
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Psychiatric Associates

  • Psychiatry Physician
  • Huntersville, NC
  • NPI 1407306194
  NPD
• The Presbyterian Hospital

  dba Novant Health Presbyterian Internal Medicine

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1376870832
  NPD
• The Presbyterian Hospital

  dba Novant Health Infusion

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1740169820
  NPD
• County of Guilford

  dba Guilford County Department of Public Health

  • State or Local Public Health Clinic/Center
  • Greensboro, NC
  • NPI 1245272657
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1184785701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 ROLLING RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031535",
            "telephone_number": "336-378-9425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13815 PROFESSIONAL CENTER DR STE 100",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787951",
            "telephone_number": "704-384-1320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 S Centennial St",
            "address_purpose": "LOCATION",
            "city": "High Point",
            "state": "NC",
            "postal_code": "272605215",
            "country_code": "US",
            "telephone_number": "336-845-7946",
            "fax_number": "336-845-7601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-10-27",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "35611",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": "35611",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8922671",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mclark423797@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "211 S Centennial St",
            "city": "High Point",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272605215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Teri Cichlar
• Circle of Life International, Inc.
• Larissa Claar
• Clarity Counseling and Wellness, PLLC
• Beverly Anne-Marie Clark, CRNA
• Tyler Aaron Clark, DPT
• Courtney Lynne Claugus, PA
• Kimberly Clements, ANP
• Amiya Clemons
• Justina M. Clemons, MD

• Psychiatry Physician in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.