Individual provider Active NPI

Casey Allen Clarke, PA-C

  • Physician Assistant
  • Chapel Hill, NC
National Provider Identifier
1669839916
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-06130 Issued in NC
Practice address
102 Mason Farm Rd FL 3
Chapel Hill, NC 27514-4617
Phone
(984) 974-8875
Fax
(984) 974-6741
NPI assigned
Jan 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 0010-06130 NC
Surgical Physician Assistant 363AS0400X
Physician Assistant 363A00000X 0010-06130 NC Primary

Addresses

Primary practice location

102 Mason Farm Rd FL 3
Chapel Hill, NC 27514-4617

Mailing address

3609 SW Durham Dr
Durham, NC 27707-6507
Phone (919) 471-9622

Other practice location 1

3609 SW Durham Dr
Durham, NC 27707-6507
Phone (919) 471-9622

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cclarke219408@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160719000284 NC Practitioner - Physician Assistant 7214220946

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5221 Paramount Pkwy
Suite 420
Morrisville, NC 27560-5491

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill CurrentSince Feb 19, 2024 Accepting new patients
University of North Carolina at Chapel Hill CurrentSince Feb 19, 2024 Accepting new patients
Park Ophthalmology Past Accepting new patients

Locations

1350 Raleigh Rd
Chapel Hill, NC 27517
Phone (984) 974-4110

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

102 Mason Farm Rd
Fl 3
Chapel Hill, NC 27514
Phone (984) 974-8875

102 Mason Farm Rd
Chapel Hill, NC 27514
Phone (919) 966-1459

5221 Paramount Pkwy
Ste 420
Morrisville, NC 27560
Phone (984) 215-6533

Interoperability endpoints

  • Direct secure messaging: cclarke219408@direct.unc.nchie.net

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1453075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1669839916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3609 SW DURHAM DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076507",
            "telephone_number": "919-471-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MASON FARM RD FL 3",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144617",
            "telephone_number": "984-974-8875",
            "fax_number": "984-974-6741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3609 SW Durham Dr",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277076507",
            "country_code": "US",
            "telephone_number": "919-471-9622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "CASEY",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-18",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "NC",
            "license": "0010-06130",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cclarke219408@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDC/CDD/TXT",
            "address_1": "102 Mason Farm Rd Fl 3",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275144617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.