ELIZABETH ANNE CLARK MD, MPH
NPI 1295430700
Student in an Organized Health Care Education/Training Program in Charlotte, NC

Q: What is Elizabeth Clark's NPI number?

The NPI number for Elizabeth Clark is 1295430700. It was assigned to this individual provider in the NPPES registry on April 3, 2023.

Q: What is Elizabeth Clark's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Elizabeth Clark was last updated on April 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since April 03, 2023PECOS Enrolled

1000 BLYTHE BLVD, SUITE 601, CHARLOTTE, NC 28203(704) 355-7874(704) 355-5619 Get Directions Write a Review

NPPES record last updated: April 3, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Elizabeth Anne Clark Md, Mph NPPES

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

ELIZABETH ANNE CLARK MD, MPH (NPI 1295430700) is an individual student in an organized health care education/training program in Charlotte, North Carolina and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1295430700

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameELIZABETH ANNE CLARKCredential: MD, MPH

Location Address1000 BLYTHE BLVD, SUITE 601Charlotte, NC 28203-5812

Mailing Address1204 Copper Hill Road, Po Box 169Glen Haven, CO 80532 · (970) 372-8832

Phone(704) 355-7874

Fax(704) 355-5619

Sole ProprietorNo

Enumeration DateApril 3, 2023

NPPES CertifiedApril 3, 2023

✔ NPI 1295430700 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1000 BLYTHE BLVD, Charlotte, NC 28203

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elizabeth Anne Clark Md, Mph 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.

Other Providers at the Same Location NPPES 20

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

JENNIFER EGAN M.D.

Pathology (Clinical Pathology/Laboratory Medicine)