Carolyn R Clark, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3038ATI Issued in OR

Practice address

1601 SW Archer Rd
Gainesville, FL 32608-1197

Phone

(352) 271-5996

Fax

(352) 384-7602

NPI assigned

Jul 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Carolyn Clark Huggett Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Reynolds Optical

  • Optician
  • Portland, OR
  • NPI 1669621207
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1962416172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8046 SW 62ND LN",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326088501",
            "telephone_number": "503-984-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081197",
            "telephone_number": "352-271-5996",
            "fax_number": "352-384-7602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CAROLYN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3038ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "HUGGETT",
            "middle_name": "CLARK",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Aijha Clark, MS, LAT, ATC
• Amanda N Clark, RN
• Antanae Shariah Clark
• Arianna Clark, RBT
• Arthur E. Clark, D.M.D.
• Chelsea Diamond Clark
• Chyn-Ni Hu Clark, O.D.
• Connetra Lashan Clark
• Danielle Clark, LMHC
• Jaime Clark

• Optometrist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.