David Anthony Clark, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

0101032223 Issued in VA

Practice address

11453 Abbots Cross LN
Glen Allen, VA 23059-1102

Phone

(804) 347-4357

NPI assigned

Jan 8, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, VI2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dclark1102088@valleyhealth.direct-ci.com

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.

• App of Tennessee Ed, PLLC

  • Emergency Medicine Physician
  • Maryville, TN
  • NPI 1003230236

  VA

  Medicare reassignment NPD
• Governor Juan F. Luis Hospital & Medical Center

  • General Acute Care Hospital
  • Christiansted, St. Croix, VI
  • NPI 1972503647
  Medicare reassignment NPD
• Advanced Family Practice

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1881792661
  NPD (past) Authorized official
• Governor Juan F. Luis Hospital & Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • St Croix, VI
  • NPI 1740238534
  NPD
• Family Practice Associates of Chesterfield PC

  • Family Medicine Physician
  • Midlothian, VA
  • NPI 1306884820
  NPD (past)
• Professional Emergency Care, PC

  • Emergency Medicine Physician
  • Honesdale, PA
  • NPI 1861671091
  NPD (past)

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1659518926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11453 ABBOTS CROSS LN",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230591102",
            "telephone_number": "804-347-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11453 ABBOTS CROSS LN",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230591102",
            "telephone_number": "804-347-4357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "759 S Main St",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "VA",
            "postal_code": "226641154",
            "country_code": "US",
            "telephone_number": "540-459-1100",
            "fax_number": "540-459-1121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DAVID",
        "middle_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-08",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101032223",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101032223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Christman, NP
• Suzanne M Christopher, LCSW
• Walter J Chun, MD
• Tyquan Churchwell, RN
• Circle of Love Companion & Home Care SVS
• James Robert Clark
• Clinton J. Norris, D.D.S., P.C.
• Antoinette Bartolotta Coe, PHARM.D.
• Letitia Aleshia Cofield, NURSE PRACTITIONER
• Merle Colglazier

• Emergency Medicine Physician in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Emergency Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.