Denise Vernall Clark, EMT

Primary specialty

Intermediate Emergency Medical TechnicianTaxonomy code 146M00000X

License

35838 Issued in GA

Practice address

258 S Thomas Street
Elberton, GA 30635

Phone

(706) 283-5837

Fax

(706) 283-5837

NPI assigned

May 7, 2008

Last updated

May 7, 2008By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Emergency Medical Technician

State licenses

Practice roles

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.

• City of Angels

  • Private Vehicle
  • Elberton, GA
  • NPI 1215106422
  NPD (past) Authorized official

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210118400000",
    "number": "1194991349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 S THOMAS STREET",
            "city": "ELBERTON",
            "state": "GA",
            "postal_code": "30635",
            "telephone_number": "706-283-5837",
            "fax_number": "706-283-5837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 S THOMAS STREET",
            "city": "ELBERTON",
            "state": "GA",
            "postal_code": "30635",
            "telephone_number": "706-283-5837",
            "fax_number": "706-283-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DENISE",
        "middle_name": "VERNALL",
        "name_prefix": "Ms.",
        "credential": "EMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-07",
        "last_updated": "2008-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146M00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Intermediate",
            "state": "GA",
            "license": "35838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edwin S. Campbell, DMD
• Carter Emergency Physicians
• Amanda Erwin Chandler, DMD
• Paul Chukelu, M.D. M.P.H
• City of Angels
• Jennifer Starrett Coble, FNP-BC
• Marlee Campbell Colquitt, M.ED., CCC-SLP
• Mark Lassiter Daniel, M.D.
• Emily Anne Daniels
• Don R Dye OD

• Intermediate Emergency Medical Technician in Elberton, GA
• Providers in Elberton, GA by specialty
• Intermediate Emergency Medical Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.