Edwina Clarke, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD470063 Issued in PA

Practice address

2 W Crescent Park
Warren, PA 16365-2199

Phone

(814) 723-3300

NPI assigned

Mar 5, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edwinaclarke@directaddress.net

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.

• Warren General Hospital

  • Cardiology Technician
  • Warren, PA
  • NPI 1154363992
  Medicare reassignment NPD
• Warren General Hospital

  dba d/b/a Warren Medical Group

  • Family Medicine Physician
  • Warren, PA
  • NPI 1508803701
  Medicare reassignment NPD
• Warren General Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Warren, PA
  • NPI 1407199227
  NPD
• Warren General Hospital

  • General Acute Care Hospital
  • Warren, PA
  • NPI 1659360220
  NPD (past)
• Warren Medical Group Inc

  • Internal Medicine Physician
  • Warren, OH
  • NPI 1982610788
  NPD (past)

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1619360351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 W CRESCENT PARK",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652111",
            "telephone_number": "814-730-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W CRESCENT PARK",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652199",
            "telephone_number": "814-723-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "EDWINA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-05",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD470063",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Children's Center for Treatment and Education (Beacon Light Behavioral Health System)
• Shelby Chimiak, CRNP
• Megan Sue Church, DO
• City of Warren
• Nicole Marie Clark, M.S. R.D.
• Beverly Ann Clever, COTA
• Frank David Clifford, MD
• Clinical Therapeutics Inc (CTI Physical Therapy)
• Community Anesthesia Services, LLC
• Community Eye Care Specialists, P.C.

• Pediatrics Physician in Warren, PA
• Providers in Warren, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.