Jaime Clark

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-14109 Issued in NC

Practice address

112 Mikel CT
Summerville, SC 29485-4806

Phone

(774) 313-0827

NPI assigned

Dec 6, 2023

Sex

Male

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 NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medac Health Services PAGroup PAC ID 1254220809, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medac Health Services, PA

  • Emergency Medicine Physician
  • Wilmington, NC
  • NPI 1356345920
  Medicare reassignment Care Compare group NPD
• Ecep II PA

  • Emergency Medicine Physician
  • Burgaw, NC
  • NPI 1255407680
  Medicare reassignment
• Medac Health Services, PA

  • Emergency Medicine Physician
  • Wilmington, NC
  • NPI 1346745098
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Novant Health New Hanover Regional Medical Center LLC

  • General Acute Care Hospital
  • Wilmington, NC
  • NPI 1376139139
  Care Compare affiliation

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

{
    "created_epoch": "1701820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1952178303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MIKEL CT",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294854806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MIKEL CT",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294854806",
            "telephone_number": "774-313-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JAIME",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-06",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-14109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Dianne Churchill, FNP
• Sarah Cieplenski, RN
• Cherrie Dawn Claeys
• Tracy Clapp, PHARMD
• Chelsea Clark
• Natalie M Clark
• Sharon Lee Clark, DMD
• Susan Clark
• Andrea Clayton, DPT
• Taylor Cleeve

• Physician Assistant in Summerville, SC
• Providers in Summerville, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.
• 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.