Laurence J Clark, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101030440 Issued in VA

Practice address

8101 Hinson Farm Rd
#119
Alexandria, VA 22306-3403

Phone

(703) 799-7300

Fax

(703) 799-8767

NPI assigned

Nov 30, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5073/brand/1/csg/1/fhir/r4

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.

• Northern Virginia Internal Medicine

  • Specialist
  • Alexandria, VA
  • NPI 1134244320

  Internal Medicine

  NPD Authorized official

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1659355113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 HINSON FARM RD",
            "address_2": "#119",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223063403",
            "telephone_number": "703-799-7300",
            "fax_number": "703-799-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 HINSON FARM RD",
            "address_2": "#119",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223063403",
            "telephone_number": "703-799-7300",
            "fax_number": "703-799-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LAURENCE",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101030440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM HEALTHKEEPERS",
            "identifier": "065941",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO MEDICARE RAILROAD",
            "identifier": "409113518",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6086659",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cleophus Benson Clark, DDS
• David Clark Jr., M.D.
• Deja Clark
• Jacob A Clark, MD
• Kerry Clark, APRN, AGNP-BC
• Sarah Clark, BCBA
• Thomas H Clark, MD
• Tilden David Clark, O.D.
• Aaliyah Clarke
• Cynthia Clarke, PT

• Internal Medicine Physician in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.