Caroline Shaffner Clark, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-07961 Issued in NC

Practice address

2001 Randolph Rd
Charlotte, NC 28207-1215

Phone

(704) 323-2000

NPI assigned

Jul 16, 2015

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 3

Other names 1

• Caroline A. Shaffner Former name

Medicare fee-for-service enrollment

Enrolled in SC, NC2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

OrthocarolinaGroup PAC ID 2062316821, 288 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171

Merit-based Incentive Payment System (MIPS)

Final score

94 of 100Reported as apm

Quality

81.63

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Orthocarolina

  • Orthopaedic Surgery Physician
  • Charlotte, NC
  • NPI 1497704217

  NC

  Medicare reassignment
• Prisma Health Medical Group-Midlands

  • Multi-Specialty Clinic/Center
  • Columbia, SC
  • NPI 1275988321

  SC

  Medicare reassignment
• Orthocarolina, PA

  • Orthopaedic Surgery Physician
  • Huntersville, NC
  • NPI 1689691479

  Physician Assistant

  NPD
• Orthocarolina

  • Orthopaedic Surgery Physician
  • Indian Land, SC
  • NPI 1619641453

  Physician Assistant

  NPD
• Palmetto Health - University of South Carolina Medical Group

  • Family Medicine Physician
  • Sumter, SC
  • NPI 1295211894
  NPD
• Prisma Health Medical Group-Midlands

  • Durable Medical Equipment & Medical Supplies
  • Columbia, SC
  • NPI 1881469856
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Novant Health Matthews Medical Center LLC

  • General Acute Care Hospital
  • Matthews, NC
  • NPI 1063463156

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1992189237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092290",
            "telephone_number": "704-323-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071215",
            "telephone_number": "704-323-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Medical Park Rd",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036808",
            "country_code": "US",
            "telephone_number": "803-434-6812",
            "fax_number": "803-434-7306",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Medical Park Rd",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036808",
            "country_code": "US",
            "telephone_number": "803-434-6812",
            "fax_number": "803-434-7306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CAROLINE",
        "middle_name": "SHAFFNER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-16",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC #",
            "identifier": "0397730004",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2293PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE #",
            "identifier": "2355",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINE",
            "last_name": "SHAFFNER",
            "middle_name": "A.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Abigail Rose Clark
• Amy Wilson Clark, NP
• Brittany Alexis Clark, MSW
• Brittany J Clark
• Brock Stephen Clark, DO
• Chelsey Clark
• Christa Leigh Clark, PA
• Christian Clark, MD
• Cierra Clark
• Deirdre V Clark, DC, ND, CHT, CCRA

• All providers in Charlotte, NC
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.