Juliana Jackson Clark, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

200300622 Issued in NC

Practice address

2406 Blue Ridge Rd
Suite 100
Raleigh, NC 27607-6678

Phone

(919) 786-5001

Fax

(919) 786-5051

NPI assigned

Feb 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: julianaclark@jmp.allscriptsdirect.net

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.

• Jeffers Mann & Artman Pediatric & Adolesent Medicine PA

  • Pediatric Adolescent Medicine Physician
  • Raleigh, NC
  • NPI 1962466631
  Medicare reassignment

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982675344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 BLUE RIDGE RD",
            "address_2": "SUITE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076678",
            "telephone_number": "919-786-5001",
            "fax_number": "919-786-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2406 BLUE RIDGE RD",
            "address_2": "SUITE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076678",
            "telephone_number": "919-786-5001",
            "fax_number": "919-786-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JULIANA",
        "middle_name": "JACKSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NC",
            "license": "200300622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "138NX",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89138NX",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika L. Clark, MD
• Faith Marrissa Clark, RPH.
• George Thomas Clark III, MD
• Jill Page Clark, COTA/L
• Jon Clark
• Karolina Ostapkiewicz Clark, C.P.O.
• Kendall Leigh Clark, PA-C
• Ladonna M Clark, MA, LCAS
• Lauren Clark, OTR/L
• Martin Vincent Clark Jr., DDS

• Pediatric Adolescent Medicine Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Pediatric Adolescent Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.