NPIMap

Individual provider Active NPI

Sydney Michelle Clark, M.D.

  • Family Medicine Physician
  • Cary, NC
National Provider Identifier
1669868956
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2018-00763 Issued in NC
Practice address
540 New Waverly PL Ste 200
Cary, NC 27518-7422
Phone
(919) 954-4159
NPI assigned
Apr 13, 2015
Last updated
Mar 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1669868956 NC
Family Medicine Physician 207Q00000X 2018-00763 NC Primary

Addresses

Primary practice location

540 New Waverly PL Ste 200
Cary, NC 27518-7422

Mailing address

5213 S Alston Ave
Durham, NC 27713-4430
Phone (919) 620-4855

Other practice location 1

2085 Frontis Plaza Blvd
Winston Salem, NC 27103-5614
Phone (336) 481-8655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181002003563 NC Practitioner - Family Practice 8921317702 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

10810 Mallard Creek Rd
Charlotte, NC 28262-9786
Phone (704) 510-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1669868956NCMDFamily Medicine Physician
2018-00763NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physicians Family Medicine CurrentSince Sep 10, 2018 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 28, 2025 Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 28, 2025 Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine CurrentSince Sep 10, 2018 Accepting new patients
Silas Creek Rehabilitation Center, LLC Past Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

540 New Waverly Pl
Ste 200
Cary, NC 27518
Phone (919) 954-4159

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

1901 Hillandale Rd
Ste D
Durham, NC 27705
Phone (919) 383-4355

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

7021 Harps Mill Rd
Ste 100
Raleigh, NC 27615
Phone (919) 576-8480

7200 Creedmoor Rd
Ste 208
Raleigh, NC 27613
Phone (919) 327-1650

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2085 Frontis Plaza Blvd
Winston Salem, NC 27103
Phone (336) 277-7226

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: sclark247466@direct.novanthealth.org

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
SalemtowneWinston Salem, NC, CCN 345479 Skilled nursing facility Adp of the SNF Jan 1, 2022
Silas Creek Rehabilitation CenterWinston Salem, NC, CCN 345003 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 31, 2025
Mar 31, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1669868956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5213 S ALSTON AVE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277134430",
            "telephone_number": "919-620-4855",
            "fax_number": "919-620-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 NEW WAVERLY PL STE 200",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187422",
            "telephone_number": "919-954-4159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2085 Frontis Plaza Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271035614",
            "country_code": "US",
            "telephone_number": "336-481-8655",
            "fax_number": "336-277-9165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SYDNEY",
        "middle_name": "MICHELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "1669868956",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2018-00763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.