Active NPI
Thomas H Clark, MD
- Emergency Medicine Physician
- Alexandria, VA
National Provider Identifier
1699762708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Practice address
- 4320 Seminary Road
Alexandria Hospital
Alexandria, VA 22304 - Phone
- (703) 504-3066
- Fax
- (703) 504-3866
- NPI assigned
- Oct 4, 2005
- Last updated
- Dec 28, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | VA | Primary |
Addresses
Primary practice location
4320 Seminary Road
Alexandria Hospital
Alexandria, VA 22304
Mailing address
1300 Piccard Dr
Suite 202 Emergency Medicine Associates
Rockville, MD 20850-4303
Phone (301) 921-7900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00608745 | Medicaid | VA | |
| 0111 | Other | CARE FIRST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010104267 | VA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-Atlantic Critical Care Services,L.L.C. | Past | Accepting new patients | |
| Emergency Medicine Associates | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 2
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.
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- NPI 1164455853
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198800000000",
"number": "1699762708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 PICCARD DR",
"address_2": "SUITE 202 EMERGENCY MEDICINE ASSOCIATES",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208504303",
"telephone_number": "301-921-7900",
"fax_number": "301-921-7915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4320 SEMINARY ROAD",
"address_2": "ALEXANDRIA HOSPITAL",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "22304",
"telephone_number": "703-504-3066",
"fax_number": "703-504-3866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "THOMAS",
"middle_name": "H",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-04",
"last_updated": "2007-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "VA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00608745",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE FIRST",
"identifier": "0111",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.