Douglas Clark, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

29465 Issued in NC

Practice address

2100 Erwin Rd
Duke Univ Med Center
Durham, NC 27710

Phone

(919) 620-4467

NPI assigned

Oct 25, 2006

Last updated

Jan 29, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dclark4679@direct.medicine.duke.edu

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.

• Duke University Affiliated Physicians, Inc.

  dba Sutton Station Internal Medicine

  • Internal Medicine Physician
  • Durham, NC
  • NPI 1316975972
  Medicare reassignment NPD
• Duke University Affiliated Physicians, Inc.

  dba Duke Urgent Care

  • Emergency Medicine Physician
  • Raleigh, NC
  • NPI 1710120795
  NPD
• Duke University Affiliated Physicians, Inc.

  dba Durham Pediatrics

  • Pediatrics Physician
  • Durham, NC
  • NPI 1740225929
  NPD
• Duke University Affiliated Physicians, Inc.

  dba Duke Primary Care

  • Family Medicine Physician
  • Durham, NC
  • NPI 1225073554
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1710061429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DURHAM PEDIATRICS",
            "address_2": "2609 N DUKE ST STE 1000",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27704",
            "telephone_number": "919-684-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 ERWIN RD",
            "address_2": "DUKE UNIV MED CENTER",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27710",
            "telephone_number": "919-620-4467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DOUGLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "29465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Marie Clark, FNP
• Clayton Michael Clark
• David James Clark, D.C.
• Demetrice Clark, OD
• Deshya Lynise Clark
• Isabel Anna Clark, MD
• Jessie Ann Clark, OTR/L
• Joseph Brian Clark, MD
• Kathryn M Clark, CRNA
• Marlo Clark

• Pediatrics Physician in Durham, NC
• Providers in Durham, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; 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.