Teresa Elaine Clark, M.D. PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

020417 Issued in GA

Practice address

2920 S Pharr CT NW
Atlanta, GA 30305-2104

Phone

(404) 261-9043

Fax

(404) 581-5440

NPI assigned

Jul 11, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Pharr Court Associates L.P.

  dba Nursecare of Buckhead

  • Skilled Nursing Facility
  • Atlanta, GA
  • NPI 1831175652
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1538194261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 LANIER PARK DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012059",
            "telephone_number": "770-532-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 S PHARR CT NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052104",
            "telephone_number": "404-261-9043",
            "fax_number": "404-581-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TERESA",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "M.D. PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "020417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00211758A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha March Clark, D.C.
• Seth Benjamin Clark, BCBA
• Sydney Clark
• Tammy Anna Clark, CRNA
• Tanisha Clark, PHD
• Urian Clark, DPT
• Vergena Montgomery Clark, MD
• Victoria Alexandria Clark, APRN
• Wanda Mae Clark
• Yakia Denise Clark

• Internal Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; 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.