Individual provider Active NPI

Nancy Claire Clark, M.D.

  • Psychiatry Physician
  • Bethesda, MD
National Provider Identifier
1730199688
Registry record updated Dec 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D32440 Issued in MD
Practice address
5918 Greentree Rd
Bethesda, MD 20817-3460
Phone
(301) 493-4431
Fax
(301) 493-4451
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X D32440 MD Primary

Addresses

Primary practice location

5918 Greentree Rd
Bethesda, MD 20817-3460

Mailing address

5918 Greentree Rd
Bethesda, MD 20817-3460
Phone (301) 493-4431

Other identifiers 1

IdentifierTypeStateIssuer
175621400MedicaidMD

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

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292544000000",
    "number": "1730199688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5918 GREENTREE RD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208173460",
            "telephone_number": "301-493-4431",
            "fax_number": "301-493-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5918 GREENTREE RD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208173460",
            "telephone_number": "301-493-4431",
            "fax_number": "301-493-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "NANCY",
        "middle_name": "CLAIRE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2010-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D32440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175621400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.