Stacy Suzanne Clark, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104555884 Issued in VA

Practice address

6 Ebco Circle
Waynesboro, VA 22980

Phone

(540) 946-2311

Fax

(540) 946-2312

NPI assigned

May 23, 2006

Last updated

Dec 30, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 VA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Virginia Chiropractic and Natural Health Center Inc.

  • Chiropractor
  • Waynesboro, VA
  • NPI 1922215565
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1801841606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 EBCO CIRCLE",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "22980",
            "telephone_number": "540-946-2311",
            "fax_number": "540-946-2312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 EBCO CIRCLE",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "22980",
            "telephone_number": "540-946-2311",
            "fax_number": "540-946-2312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "STACY",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104555884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlottesville League of Therapists, Inc.
• Kimberly M Cheek, MD
• David B Chernoff, MD
• Pei-Chun Jenny Chu, PHARMD
• Kathleen J Clark-Gelburd, OPTOMETRIST
• Erica Clinton, LPTA
• Robert Jonas Collins, D.M.D.
• Commonwealth of Virginia State Board of Health (Waynesboro Augusta Health Department)
• Community Alternatives Virginia, Inc.
• Community Living Services

• Chiropractor in Waynesboro, VA
• Providers in Waynesboro, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.