Ileha M Clark

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Practice address

152 New St Ste 103M
Macon, GA 31201-7304

Phone

(478) 508-7124

NPI assigned

Apr 23, 2019

Last updated

May 3, 2019By the provider in NPPES

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

Other names 1

• Mrs. Ileha Clark Robinson Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Genesis Around the Clock Care LLC

  • Home Health Agency
  • Macon, GA
  • NPI 1952138513
  NPD

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1619531936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 NEW ST STE 103M",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017304",
            "telephone_number": "478-259-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 NEW ST STE 103M",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017304",
            "telephone_number": "478-508-7124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ILEHA",
        "middle_name": "M",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Genesis42019@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "152 New St Ste 103M",
            "city": "Macon",
            "state": "GA",
            "country_code": "US",
            "postal_code": "312017304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ILEHA",
            "last_name": "ROBINSON",
            "middle_name": "CLARK",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Citadel Health LLC
• Debra Clapp, PARAPROFESSIONAL, BA
• Clark General Dentistry Center, P.C.
• Casey Daniel Clark, NP
• Edward K Clark, MD
• Julie J Clark, FNP-BC
• Kameron Alexander Clark, MD
• Kiofa Enez Clark, D.C.
• Lauren Clark
• Lowell Clark, MD

• PACE Provider Organization in Macon, GA
• Providers in Macon, GA by specialty
• PACE Provider Organization in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; 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.