Megan Jo Clark, P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA.0003925 Issued in CO

Practice address

8301 E Prentice Ave Ste 125
Greenwood Village, CO 80111-2989

Phone

(303) 771-3939

Fax

(303) 771-4949

NPI assigned

Oct 12, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Megan Jo Clement Former name

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

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.

• DTC Family Health and Walk-in L L C

  • Family Medicine Physician
  • Greenwood Village, CO
  • NPI 1609817444
  Medicare reassignment
• Phoenix Medical Group, P.C.

  • Pulmonary Disease Physician
  • Peoria, AZ
  • NPI 1316952971
  NPD (past)

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1982989885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 E PRENTICE AVE STE 125",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112989",
            "telephone_number": "303-771-3939",
            "fax_number": "303-771-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 E PRENTICE AVE STE 125",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112989",
            "telephone_number": "303-771-3939",
            "fax_number": "303-771-4949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12605 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "80045",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12605 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "80045",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MEGAN",
        "middle_name": "JO",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-12",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5014",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0003925",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0003925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1982989885",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "CLEMENT",
            "middle_name": "JO",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Woosik Michael Chung, M.D.
• Lisa Ciazza, RN
• Anya Wanda Cieszewski, CAA
• Cindi Tyler
• Evan Masland Clark, LPCC
• Rianne Clark, FNP
• Christa Clarke, MA, LPC
• Marcia A Clarke, P.T.
• Clear View Counseling and Consulting, LLC
• Ashli K Clearwater, R.N., FNP

• Medical Physician Assistant in Greenwood Village, CO
• Providers in Greenwood Village, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; 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.