Charles Amos Clark, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

56206 Issued in TN

Practice address

Vanderbilt University Dept of Medicine
D-3100, Medical Center North
Nashville, TN 37232

Phone

(615) 322-0417

NPI assigned

May 2, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Internal MedicineAlso: Hematology/Oncology

Education

University of Tennessee, HSC, College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vanderbilt University Medical CenterGroup PAC ID 5092023416, 3,510 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Suncrest Home Health Home health agency, Nashville, TN, CCN 447403
• Vanderbilt Home Care Services Home health agency, Nashville, TN, CCN 447249
• Vanderbilt University Medical Center Hospital, Nashville, TN, CCN 440039

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cclark78832@direct.vumc.org

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.

• Vanderbilt University Medical Center

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1104202761
  Medicare reassignment Care Compare group NPD
• Vanderbilt University

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1235154972
  NPD (past)
• Vanderbilt University

  • Clinical Social Worker
  • Nashville, TN
  • NPI 1285659706
  NPD (past)

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

• Suncrest Healthcare of Middle TN, LLC

  • Home Health Agency
  • Nashville, TN
  • NPI 1326103706
  Care Compare affiliation
• Vanderbilt Home Care Services, LLC

  • Home Health Agency
  • Nashville, TN
  • NPI 1235293655
  Care Compare affiliation
• Vanderbilt University Medical Center

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1396882205
  Care Compare affiliation

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648252800000",
    "number": "1649680406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691",
            "telephone_number": "615-936-2000",
            "fax_number": "615-936-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VANDERBILT UNIVERSITY DEPT OF MEDICINE",
            "address_2": "D-3100, MEDICAL CENTER NORTH",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37232",
            "telephone_number": "615-322-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHARLES",
        "middle_name": "AMOS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-02",
        "last_updated": "2022-03-26",
        "certification_date": "2022-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TN",
            "license": "56206",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "56206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q031277",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cclark78832@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "Vanderbilt University Dept Of Medicine",
            "address_2": "D-3100, Medical Center North",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cara Elizabeth Clark
• Carissa Clark
• Carol A Clark, ARNP-C
• Carolina Wilcox Clark, M.D., M.P.H.
• Chanella Latre Clark, LPCC
• Connie Renea Clark, LPN
• Corbin Ross Clark
• Craig Anthony Clark, M.D.
• David Nelson Clark, MPT
• Eric Christopher Clark, AGACNP

• Internal Medicine Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2022; 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.
• 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.