Active NPI
Caroline Carmela Clark, M.D.
- Psychiatry Physician
- Fort Sill, OK
National Provider Identifier
1972933810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0101256935
- Practice address
- 4301 Wilson St
Fort Sill, OK 73503-4472 - Phone
- (580) 442-4678
- NPI assigned
- Nov 13, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0101256935 | VA | Primary |
Addresses
Primary practice location
4301 Wilson St
Fort Sill, OK 73503-4472
Mailing address
8901 Rockville Pike
Bethesda, MD 20889-0001
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101256935 | VA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537142400000",
"number": "1972933810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8901 ROCKVILLE PIKE",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208890001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4301 WILSON ST",
"city": "FORT SILL",
"state": "OK",
"postal_code": "735034472",
"telephone_number": "580-442-4678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "CAROLINE",
"middle_name": "CARMELA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-13",
"last_updated": "2018-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0101256935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Sill, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.