Vergena Montgomery Clark, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

56987 Issued in GA

Practice address

3142 Esplanade Cir SW
Atlanta, GA 30311-4221

Phone

(404) 441-1365

Fax

(210) 428-6384

NPI assigned

Aug 13, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Vergena Patrica Montgomery Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1326527144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "404-441-1365",
            "fax_number": "210-428-6384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3142 ESPLANADE CIR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303114221",
            "telephone_number": "404-441-1365",
            "fax_number": "210-428-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "VERGENA",
        "middle_name": "MONTGOMERY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME76527",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "56987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VERGENA",
            "last_name": "MONTGOMERY",
            "middle_name": "PATRICA",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Sydney Clark
• Tammy Anna Clark, CRNA
• Tanisha Clark, PHD
• Teresa Elaine Clark, M.D. PC
• Urian Clark, DPT
• Victoria Alexandria Clark, APRN
• Wanda Mae Clark
• Yakia Denise Clark
• Clarke ABA Consulting LLC
• Alexis Clarke

• 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 Aug 26, 2022; 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.