Timothy Clark, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5291 Issued in NC

Practice address

306 Muirs Chapel Rd Ste a
Greensboro, NC 27410-6178

Phone

(336) 852-2222

Fax

(336) 852-4844

NPI assigned

Apr 21, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Clark Chiropractic Offices

  • Chiropractor
  • Greensboro, NC
  • NPI 1316726144
  Medicare reassignment NPD Authorized official
• Vardy Chiropractic and Wellness Clinics

  dba Wendell Family Chiropractic

  • Chiropractor
  • Wendell, NC
  • NPI 1366525149
  Medicare reassignment NPD

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1629650502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 MUIRS CHAPEL RD STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274106178",
            "telephone_number": "336-852-2222",
            "fax_number": "336-852-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 MUIRS CHAPEL RD STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274106178",
            "telephone_number": "336-852-2222",
            "fax_number": "336-852-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TIMOTHY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-21",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "5291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Lee Clark, PA-C
• Preston Samuel Clark Jr., MD
• Rebecca Ann Clark, OTR
• Ryonna Lanae Clark
• Sherry L. Clark, N.P.
• William D Clark, MD
• Daniel Clarke-Pearson, MD
• Jacqueline Clarke, RN
• Leah Clarke, MS, NCC
• Nettie Rose Clarke, MS., CRC., LPC.

• Chiropractor in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.