Sherri Bennett Clark, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12122 Issued in AL

Practice address

4745 Chace Cir
Suite 101
Hoover, AL 35244-3711

Phone

(205) 733-7110

Fax

(205) 733-7859

NPI assigned

Sep 6, 2006

Last updated

Jan 3, 2014By the provider in NPPES

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

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sherri.clark.1@9069.direct.athenahealth.com

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.

• Vincentian Physician Services LLC

  • Family Medicine Physician
  • Birmingham, AL
  • NPI 1851698310
  Medicare reassignment NPD

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1225131311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 CHACE CIR",
            "address_2": "SUITE 101",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352443711",
            "telephone_number": "205-733-7110",
            "fax_number": "205-733-7859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 CHACE CIR",
            "address_2": "SUITE 101",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352443711",
            "telephone_number": "205-733-7110",
            "fax_number": "205-733-7859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SHERRI",
        "middle_name": "BENNETT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "12122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129690",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SC00078589",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• City of Hoover
• Layla Faith Clark
• Megan Clark, RD, LD
• Michael Ray Clark, RPH
• Noah Clark
• Pharris Clayton
• Mickalyn Summerford Clemons
• Larynn Clopton
• Jakobson Cobb
• Jessica Cockrell

• Family Medicine Physician in Hoover, AL
• Providers in Hoover, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; 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.