Mattie Mae Farmer Clark, CST/CSFA

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

Practice address

Piedmont Fayette Hospital
1255 Highway 54 West
Fayetteville, GA 30214

Phone

(770) 719-7000

NPI assigned

Nov 5, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1891263299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 COVINGTON TER",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302635771",
            "telephone_number": "386-295-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PIEDMONT FAYETTE HOSPITAL",
            "address_2": "1255 HIGHWAY 54 WEST",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-719-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARMER CLARK",
        "first_name": "MATTIE",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "credential": "CST/CSFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-05",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salih O Faldon, M.D.
• Families United Services, Inc.
• Family Healthcare, LLC
• Family Medicine Specialist, PC
• Lindsey Bryant Fannin
• Shamarra Jackson Farmer, RN
• Toniya Marie Farmer, DPT
• Fayette Care Clinic
• Fayette Community Hospital, Inc.
• Fayette County Board of Health

• All providers in Fayetteville, GA
• Surgical Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; 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.