Robert Clark, N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

5006585 Issued in NC

Practice address

Employee and Occupational Health
Medical Center Boulevard
Winston Salem, NC 27157-0001

Phone

(734) 474-6325

Fax

(336) 716-6127

NPI assigned

May 3, 2007

Sex

Male

Sole proprietor

Yes

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

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: rclark2848906@carolinashealthcaresystem.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cardiology and Vascular Associates PC

  dba Medical Care corporation

  • Family Nurse Practitioner
  • Bloomfield Hills, MI
  • NPI 1740473396

  Adult Health

  NPD (past)
• Cardiology and Vascular Associates PC

  dba Medical Care Corporation

  • Internal Medicine Physician
  • Bloomfield Hills, MI
  • NPI 1962478743
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386201600000",
    "number": "1376765925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 BIRCH CREEK TRL",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271066510",
            "telephone_number": "734-474-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EMPLOYEE AND OCCUPATIONAL HEALTH",
            "address_2": "MEDICAL CENTER BOULEVARD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "734-474-6325",
            "fax_number": "336-716-6127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2013-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5006585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Clark, M.S. CCC-SLP
• Meredith Renae Clark, APNP
• Precious Sharde Clark, LPN
• Rachel Clark
• Reese Hunter Clark Jr., MD
• Susan R Clark, CPO
• Theodore Glenn Clark, DDS
• Todd Clark, LPC
• Tyia Shay Clark
• Yetta Hardy Clark, CRNA

• Adult Health Nurse Practitioner in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Adult Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2013; 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.