Individual provider Active NPI

Astrid Grace Clarke, MD

  • Internal Medicine Physician
  • Palm Coast, FL
National Provider Identifier
1386740595
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME119280 Issued in FL
Practice address
1 Powder Horn Dr
Palm Coast, FL 32164-6703
Phone
(203) 435-6807
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 038741 CT
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME119280 FL Primary

Addresses

Primary practice location

1 Powder Horn Dr
Palm Coast, FL 32164-6703

Mailing address

1 Powder Horn Dr
Palm Coast, FL 32164-6703
Phone (203) 435-6807

Other identifiers 1

IdentifierTypeStateIssuer
001387415MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180509001473 FL Practitioner - Internal Medicine 0749383818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
038741CTMDInternal Medicine Physician
ME119280FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gaylord Hospital, Inc. Single Specialty PastSince Sep 8, 2025 Accepting new patients
Metcare of Florida, Inc Single Specialty Past Accepting new patients
Back to Health of Branford, LLC Single Specialty PastSince Jul 15, 2002 Accepting new patients
Midstate Medical Group, PC Single Specialty Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1386740595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 POWDER HORN DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321646703",
            "telephone_number": "203-435-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 POWDER HORN DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321646703",
            "telephone_number": "203-435-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "ASTRID",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "038741",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME119280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001387415",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.