Individual provider Active NPI

Megan Jo Clark, P.A.-C

  • Medical Physician Assistant
  • Greenwood Village, CO
National Provider Identifier
1982989885
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
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
Last updated
Dec 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5014 AZ
Physician Assistant 363A00000X PA.0003925 CO
Medical Physician Assistant 363AM0700X PA.0003925 CO Primary

Addresses

Primary practice location

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

Mailing address

8301 E Prentice Ave Ste 125
Greenwood Village, CO 80111-2989
Phone (303) 771-3939

Other practice location 1

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0000

Other practice location 2

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0000

Other names 1

  • Megan Jo Clement Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180420000750 CO Practitioner - Physician Assistant 8820265713 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0003925COMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "CLEMENT",
            "middle_name": "JO",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenwood Village, CO

Sources for this page

Verify at the official NPI Registry.