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TYIA SHAY CLARK
NPI 1124523188
Pediatrics in Winston Salem, NC

Active since March 29, 2018PECOS Enrolled
3746 VEST MILL RD, WINSTON SALEM, NC 27103(336) 713-0024 Get Directions Write a Review

NPPES record last updated: December 14, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 14, 2023, Jun 29, 2021, Mar 29, 2018 (3 updates tracked since 2018).

About Tyia Shay Clark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYIA SHAY CLARK (NPI 1124523188) is an individual pediatrics provider in Winston Salem, North Carolina, licensed in North Carolina (2021-01599) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS and maintains a secondary practice location in Knightdale.

NPPES Registry Identity

NPI1124523188
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameTYIA SHAY CLARK
Location Address3746 VEST MILL RDWinston Salem, NC 27103-2912
Mailing Address3746 Vest Mill RdWinston Salem, NC 27103-2912 · (336) 713-0024
Phone(336) 713-0024
Sole ProprietorNo
Enumeration DateMarch 29, 2018
Last NPPES UpdateDecember 14, 20233 updates tracked since enumeration
NPPES CertifiedDecember 14, 2023
✔ NPI 1124523188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NC · 2021-01599
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3746 VEST MILL RD, Winston Salem, NC 27103
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Secondary Practice Location 1

Location 16602 Knightdale Blvd Ste 204Knightdale, NC 27545-6567 · Phone (919) 782-5273 · Fax (919) 781-8853

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tyia Shay Clark is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHELLEY RAE KREITER MD
Pediatrics
3746 VEST MILL RD
WINSTON SALEM, NC 27103
Forsyth County (336) 716-2255
DR. JOHNATHAN D RHYNE
Pediatrics
3746 VEST MILL RD
WINSTON SALEM, NC 27103
Forsyth County (336) 774-0710
KATHARINE MEYER MD
Pediatrics
3746 VEST MILL RD
WINSTON SALEM, NC 27103
Forsyth County (336) 713-0024
REBECCA YAMIN WEINSHILBOUM DO
Pediatrics
3746 VEST MILL RD, WESTGATE PEDIATRICS
WINSTON SALEM, NC 27103
Forsyth County (336) 774-0710
KIMBERLY SAMANTHA DUNN PA-C, MMS
Physician Assistant
3746 VEST MILL RD
WINSTON SALEM, NC 27103
Forsyth County (336) 774-0710
SHAYNE ETHAN BATES M.D.
Pediatrics
3746 VEST MILL RD
WINSTON SALEM, NC 27103
Forsyth County (336) 716-2255
WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS
Pediatrics
3746 VEST MILL RD
WINSTON SALEM, NC 27103
Forsyth County (336) 774-0710

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tyia Clark's NPI number?

The NPI number for Tyia Clark is 1124523188. It was assigned to this individual provider in the NPPES registry on March 29, 2018.

Where is Tyia Clark located?

Tyia Clark practices at 3746 Vest Mill Rd, Winston Salem, NC 27103. The listed phone number is (336) 713-0024.

What is Tyia Clark's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Tyia Clark enrolled in Medicare?

Yes. Tyia Clark is registered in the Medicare PECOS enrollment system.

What insurance does Tyia Clark accept?

Health plans from AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC and UnitedHealthcare list Tyia Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tyia Clark was last updated on December 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.