Holly Michelle Clark, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

317493 Issued in NY

Practice address

410 University Parkway
Suite 2300
Aiken, SC 29801-6807

Phone

(803) 335-1219

Fax

(803) 335-1689

NPI assigned

May 8, 2007

Last updated

Jun 16, 2022By 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 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC, NY, GA, NC, FL5 enrollments

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 5

Specialty

Psychiatry

Education

Medical University of South Carolina College of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• MCCD FL Psychiatry Services PA

  dba Talkiatry

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1659003457

  GA, NC, SC, Single Specialty

  Medicare reassignment Care Compare group NPD
• South Carolina Dept of Mental Health Accounting Office

  dba Highway to Hope Tri-County Primary Care

  • Primary Care Nurse Practitioner
  • Bennettsville, SC
  • NPI 1295332690

  Single Specialty

  Medicare reassignment NPD
• MCCD Psychiatry Services PLLC

  dba Talkiatry

  • Psychiatry Physician
  • New York, NY
  • NPI 1033750823

  FL, GA, NC, SC, Single Specialty

  Medicare reassignment NPD
• South Carolina Dept of Mental Health Accounting Office

  dba Spartanburg Area Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Spartanburg, SC
  • NPI 1427168889

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1346453727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 UNIVERSITY PARKWAY",
            "address_2": "SUITE 2300",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016807",
            "telephone_number": "803-335-1219",
            "fax_number": "803-335-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 UNIVERSITY PARKWAY",
            "address_2": "SUITE 2300",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016807",
            "telephone_number": "803-335-1219",
            "fax_number": "803-335-1689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "HOLLY",
        "middle_name": "MICHELLE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "GA",
            "license": "RTP001859",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "317493",
            "primary": true
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "SC",
            "license": "33738",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "337380",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Choices, LLC
• Samantha Chostner
• Joseph Tipton Christian, CPSS
• Gail Buchanan Clamp, CCC-SLP
• Antione A Clanton
• Joshua Clark
• Michael Ericson Clark, PHARMD
• Erika Eles Clarke, PT
• Thelma Clemons
• Clemson Sports Medicine and Rehabilitation (Sports Plus Woodside)

• Psychiatry Physician in Aiken, SC
• Providers in Aiken, SC by specialty
• Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.