Alan Boyd Clark, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

34278 Issued in NC

Practice address

1875 Remount Rd
Gastonia, NC 28054-7413

Phone

(704) 874-0604

NPI assigned

Sep 27, 2005

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alan.clark@1020466096308228.direct.elationemr.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.

• Gaston Family Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gastonia, NC
  • NPI 1215932215
  Medicare reassignment NPD
• Gaston Family Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Gastonia, NC
  • NPI 1306644315
  NPD
• Wilkinson Blvd Operating Company, LLC

  • Skilled Nursing Facility
  • Gastonia, NC
  • NPI 1578355061
  NPD (past)

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1427044155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E SECOND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1904",
            "fax_number": "704-867-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 REMOUNT RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547413",
            "telephone_number": "704-874-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ALAN",
        "middle_name": "BOYD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "34278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110093323",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7922707",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N34278",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandria Chukes, MSN, APRN, AGNP-C
• Elizabeth Kathleen Clay Cirullo, DO
• CJC Consulting Services LLC
• Kathryn Claffee
• Nicole Clark-Ward, FNP-BC
• Karen Clark, CRNA
• Ladonna Brown Clark, PA-C
• Marion Clark II, PHARM D
• Renee Spangler Clark, RN
• Tavia Denise Clark, M.D.

• Internal Medicine Physician in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.