Mary K Clark

Primary specialty

OptometristTaxonomy code 152W00000X

License

2725 Issued in NC

Practice address

3701 S Main St
Hope Mills, NC 28348-1958

Phone

(910) 423-0700

NPI assigned

Apr 24, 2022

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

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of Pikeville, Kentucky College of Osteopathic Med, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Eyecare Optometry PAGroup PAC ID 9537258868, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.clark@direct.revolutionehr.com

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.

• Professional Eyecare Optometry, PA

  • Optometrist
  • Hope Mills, NC
  • NPI 1811024961

  NC, Optometrist

  Medicare reassignment Care Compare group NPD
• Professional Eye Care Optometry, PA

  • Optometrist
  • Elizabethtown, NC
  • NPI 1053972877
  NPD
• Professional Eye Care Optometry, PA

  • Optometrist
  • Eastover, NC
  • NPI 1659823813
  NPD

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

{
    "created_epoch": "1650758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1992449102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 WESTWOOD CIR",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "283377139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 S MAIN ST",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283481958",
            "telephone_number": "910-423-0700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "432 W Broad St",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "NC",
            "postal_code": "283379398",
            "country_code": "US",
            "telephone_number": "910-876-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MARY",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-24",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cedar & Stone Counseling PLLC
• Charles S. Maxwell DDS
• Shauniele Charles, M.S. CCC-SLP
• Charlotte Fitness and Wellness Center PLLC
• Krista Ciaffone
• Claymore Home
• Clinical Innovations
• Compassionate Care
• Tina Marie Cooper, MANAGER
• Cornerstone Family Dentistry

• All providers in Hope Mills, NC
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.