Individual provider Active NPI

Gilbert W Clark, PA-C

  • Physician Assistant
  • Greensboro, NC
National Provider Identifier
1629023338
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103853 Issued in NC
Practice address
1211 Virginia St
Greensboro, NC 27401-1313
Phone
(133) 627-5092
NPI assigned
May 23, 2006
Last updated
Feb 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 103853 NC Primary

Addresses

Primary practice location

1211 Virginia St
Greensboro, NC 27401-1313

Mailing address

300 W Northwood St
Greensboro, NC 27401-1324
Phone (336) 275-0927

Other practice location 1

300 W Northwood St
Greensboro, NC 27401-1324
Phone (336) 275-0927

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gclark19322@direct.conehealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040226000424 NC Practitioner - Physician Assistant 5496641334 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-7000

1200 N Elm St
Greensboro, NC 27401-1020

1211 Virginia St
Greensboro, NC 27401-1313
Phone (336) 275-0927

301 E Wendover Ave
Suite 411
Greensboro, NC 27401-1211
Phone (336) 832-3210

501 N Elam Ave
Greensboro, NC 27403-1118
Phone (336) 832-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
103853NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Aug 29, 2022 Accepting new patients
Moses Cone Physician Services, Inc. CurrentSince Dec 13, 2015 Accepting new patients
Moses Cone Physician Services Inc CurrentSince Dec 13, 2015 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation Physician Assistant CurrentSince Aug 29, 2022 Accepting new patients
Moses Cone Physician Services, Inc. Past Accepting new patients

Locations

300 E Wendover Ave
Greensboro, NC 27401
Phone (336) 663-5205

1211 Virginia St
Greensboro, NC 27401
Phone (336) 272-0012

1131 N Church St
Greensboro, NC 27401
Phone (336) 358-5100

301 E Wendover Ave
Ste 411
Greensboro, NC 27401
Phone (336) 832-3200

300 W Northwood St
Greensboro, NC 27401
Phone (336) 275-0927

Interoperability endpoints

  • Direct secure messaging: gclark19322@direct.conehealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1629023338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W NORTHWOOD ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011324",
            "telephone_number": "336-275-0927",
            "fax_number": "336-275-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 VIRGINIA ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011313",
            "telephone_number": "133-627-5092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W Northwood St",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274011324",
            "country_code": "US",
            "telephone_number": "336-275-0927",
            "fax_number": "336-275-4834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "GILBERT",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gclark19322@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1211 Virginia St",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274011313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.