Jeffrey Ira Clark, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

016221 Issued in GA

Practice address

4890 Roswell Rd NE
Suite 250
Atlanta, GA 30342-2606

Phone

(404) 255-9244

Fax

(404) 255-9114

NPI assigned

Jul 15, 2005

Last updated

Nov 10, 2015By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Family Practice Associates of Atlanta

  dba Occupational Medicine Associates

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1407905540
  NPD (past)
• Piedmont Cardiology of Atlanta, LLC

  dba Piedmont Heart Institute

  • Cardiovascular Disease Physician
  • Atlanta, GA
  • NPI 1275729691
  NPD (past)
• Piedmont Providers LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1548273592
  NPD (past)

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1316946957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4890 ROSWELL RD NE",
            "address_2": "SUITE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422606",
            "telephone_number": "404-255-9244",
            "fax_number": "404-255-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4890 ROSWELL RD NE",
            "address_2": "SUITE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422606",
            "telephone_number": "404-255-9244",
            "fax_number": "404-255-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JEFFREY",
        "middle_name": "IRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "016221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jabari Clark
• James Andrew Clark, M.D.
• Janelle Clark
• Jason A Clark, M.D.
• Javeya Clark, OD
• Jessica Taylor Clark, PT, DPT
• Johanna J Clark, CSA
• Julia Clark, LMSW
• Kathleen Linton Clark, APRN-BC
• Kathy Clark, CAT

• Internal Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.