NPIMap

Organization Active NPI

Clark Family Medicine PA

  • Family Medicine Physician
  • Newland, NC
National Provider Identifier
1306845573
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0098-01210 Issued in NC
Legal business name
CLARK FAMILY MEDICINE PA
Practice address
137 Notalee St
Newland, NC 28657
Phone
(828) 528-3009
NPI assigned
Jul 19, 2005
Last updated
Aug 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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

Authorized official

Name
Dr. Robert Dale Clark, M.D.NPI 1376542597
Title
President
Phone
(828) 528-3009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 0098-01210 NC Primary

Addresses

Primary practice location

137 Notalee St
Newland, NC 28657

Mailing address

PO Box 58
Crossnore, NC 28616-0058
Phone (828) 528-3009

Other names 1

  • Clark Family & Obstetric Care PA Former legal business name

National Provider Directory

National Provider Directory

Locations

448 Cranberry St
Newland, NC 28657
Phone (828) 737-0221

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534723200000",
    "number": "1306845573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 58",
            "city": "CROSSNORE",
            "state": "NC",
            "postal_code": "286160058",
            "telephone_number": "828-528-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 NOTALEE ST",
            "city": "NEWLAND",
            "state": "NC",
            "postal_code": "28657",
            "telephone_number": "828-528-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK FAMILY MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2018-08-20",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "828-528-3009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "0098-01210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clark Family & Obstetric Care PA",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Clark Family & Obstetric Care PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Newland, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.