Individual provider Active NPI

Cheryl Charmaine Clarke, M.D.

  • Obstetrics & Gynecology Physician
  • Fort Defiance, AZ
National Provider Identifier
1568420313
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME121900 Issued in FL
Practice address
Corner of Route N12 and N7
Fort Defiance, AZ 86504
Phone
(928) 729-8000
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME121900 FL Primary

Addresses

Primary practice location

Corner of Route N12 and N7
Fort Defiance, AZ 86504

Mailing address

PO Box 649
Fort Defiance, AZ 86504-0649

Other identifiers 1

IdentifierTypeStateIssuer
171353905MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, TX, NM, FL4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20050119000386 SC Practitioner - Obstetrics/Gynecology 8224087085 Reassigns benefits to 2 organizations
I20050314001023 TX Practitioner - Obstetrics/Gynecology 8224087085 Reassigns benefits to 5 organizations
I20140409000077 NM Practitioner - Obstetrics/Gynecology 8224087085 Reassigns benefits to 2 organizations
I20150916002261 FL Practitioner - Obstetrics/Gynecology 8224087085 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone (505) 722-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Health Clarendon Family Medicine CurrentSince Nov 27, 2019 Accepting new patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Dec 14, 2025 Accepting new patients
Central Florida Health Care, Inc. CurrentSince Jan 1, 2017 Accepting new patients
McLeod Physician Associates II CurrentSince Feb 25, 2019 Accepting new patients
Quentin N Burdick Comprehensive Health Care Facility CurrentSince Oct 24, 2016 Accepting new patients
Tuba City Regional Health Care Corporation Family Medicine Current Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc Obstetrics & Gynecology CurrentSince Apr 5, 2020 Accepting new patients
Rosebud Indian Health Service CurrentSince Jun 20, 2016 Accepting new patients
McLeod Physician Associates II CurrentSince Feb 25, 2019 Accepting new patients
The Fort Defiance Indian Hospital Board, Incorporation Current Accepting new patients
McLeod Physician Associates II Family Medicine Current Accepting new patients
Rosebud Indian Health Service CurrentSince Jun 20, 2016 Accepting new patients
DHP of Manatee PA Obstetrics & Gynecology CurrentSince Jul 1, 2021 Accepting new patients
Central Florida Health Care, Inc CurrentSince Jan 1, 2017 Accepting new patients
Tuba City Regional Health Care Corporation Family Medicine CurrentSince Oct 28, 2019 Accepting new patients
McLeod Health Clarendon Current Accepting new patients
Tuba City Regional Health Care Corporation Family Medicine CurrentSince Oct 28, 2019 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc Family Medicine CurrentSince Apr 5, 2020 Accepting new patients
McLeod Health Clarendon Obstetrics & Gynecology CurrentSince Nov 27, 2019 Accepting new patients
Central Florida Health Care, Inc. Current Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc. Current Accepting new patients
Longview Wellness Center Inc Family Medicine PastSince Jan 2, 2022 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients
Black River Healthcare, Inc. Family Medicine Past Accepting new patients
Longview Wellness Center Inc Family Medicine Past Accepting new patients

Locations

950 County Road 17A W
Avon Park, FL 33825
Phone (863) 452-3000

109 W Wall St
Frostproof, FL 33843
Phone (863) 635-4891

305 W Central Ave
Fl Heal
Lake Wales, FL 33853

1129 N Missouri Ave
Lakeland, FL 33805
Phone (863) 413-8600

200 Avenue F NE
Winter Haven, FL 33881
Phone (863) 292-4652

1514 1st St N
Winter Haven, FL 33881
Phone (863) 291-5110

47 5th St NW
Winter Haven, FL 33881

201 Magnolia Ave SW
Winter Haven, FL 33880
Phone (863) 229-7950

101 Avenue O SE
Winter Haven, FL 33880
Phone (863) 294-7010

1300 Hospital Loop
Belcourt, ND 58316

1900 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-1820

2111 College Dr
Gallup, NM 87301
Phone (505) 397-5172

1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7000

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

4100 W 150th St
#3
Cleveland, OH 44135

706 N 8th Ave
Dillon, SC 29536
Phone (843) 777-5605

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

506 E Cheves St
#202
Florence, SC 29506

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

10 E Hospital St
Manning, SC 29102
Phone (803) 433-3000

50 E Hospital St
Ste 2
Manning, SC 29102
Phone (803) 433-0797

Organizations & group practices 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1568420313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 AND N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "86504",
            "telephone_number": "928-729-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "CHERYL",
        "middle_name": "CHARMAINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME121900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171353905",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Defiance, AZ

Sources for this page

Verify at the official NPI Registry.