Organization Active NPI

Teresa E Clark MD PC

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1659412898
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TERESA E CLARK MD PC
Practice address
1003 Coronado Dr NW
Atlanta, GA 30327-3716
Phone
(404) 444-4886
Fax
(404) 581-5440
NPI assigned
Feb 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Authorized official

Name
Dr. Teresa E Clark, MD
Title
Doctor
Phone
(404) 444-4886

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1003 Coronado Dr NW
Atlanta, GA 30327-3716

Mailing address

1003 Coronado Dr NW
Atlanta, GA 30327-3716
Phone (404) 444-4886

National Provider Directory

National Provider Directory

Locations

2045 Peachtree Rd NE
Ste 400
Atlanta, GA 30309
Phone (404) 351-3974

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486598400000",
    "number": "1659412898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 CORONADO DR NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303273716",
            "telephone_number": "404-444-4886",
            "fax_number": "404-581-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 CORONADO DR NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303273716",
            "telephone_number": "404-444-4886",
            "fax_number": "404-581-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERESA E CLARK MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2017-02-09",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "404-444-4886",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; 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.