Patricia Ellen Clark, MD, MPH

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

30313 Issued in NC

Practice address

307 N Columbia St
Chapel Hill, NC 27516-2119

Phone

(919) 542-6808

NPI assigned

Apr 26, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 19, 2017 through Sep 19, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528288339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2281 LAMONT NORWOOD RD",
            "city": "PITTSBORO",
            "state": "NC",
            "postal_code": "273127002",
            "telephone_number": "919-967-5766",
            "fax_number": "919-929-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 N COLUMBIA ST",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275162119",
            "telephone_number": "919-542-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "PATRICIA",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "30313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8910964",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "22550",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan Clark
• Karen Harrell Clark, M.D.
• Leslie Horn Clark, MD
• Megan Elizabeth Clark, MA, LMFT, LPC
• Meghan Ruth Clark, MD
• Sydney Clark
• Vivian Elizabeth Clark, MD
• Wendy Auclair Clark, D.D.S.
• Casey Allen Clarke, PA-C
• Lilah E Clarke

• Psychiatry Physician in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.