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OWEN MATTHEW CLARK MD
NPI 1356145080
Student in an Organized Health Care Education/Training Program in Birmingham, AL

Active since April 02, 2025PECOS Enrolled
625 19TH ST S, BIRMINGHAM, AL 35233(205) 934-4696 Get Directions Write a Review

NPPES record last updated: April 2, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Owen Matthew Clark Md NPPES

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

OWEN MATTHEW CLARK MD (NPI 1356145080) is an individual student in an organized health care education/training program in Birmingham, Alabama and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1356145080
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameOWEN MATTHEW CLARKCredential: MD
Location Address625 19TH ST SBirmingham, AL 35233-1900
Mailing Address625 19th St SBirmingham, AL 35233-1900
Phone(205) 934-4696
Sole ProprietorNo
Enumeration DateApril 2, 2025
NPPES CertifiedApril 2, 2025
✔ NPI 1356145080 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.
625 19TH ST S, Birmingham, AL 35233
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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)

Owen Matthew Clark Md 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.

RUI ZHENG-PYWELL MD
Student in an Organized Health Care Education/Training Program
625 19TH ST S
BIRMINGHAM, AL 35233
Jefferson County (205) 975-3288
CYDNEY NICHOLE TERRYN MD
Psychiatry & Neurology (Psychiatry)
625 19TH ST S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-0727
TODD WILLIAM MUDD JR.
Student in an Organized Health Care Education/Training Program
625 19TH ST S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-2490
DAVID W MERKLEY DO
Student in an Organized Health Care Education/Training Program
625 19TH ST S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-4696
DR. SERDAR AKKOL MD, PHD
Student in an Organized Health Care Education/Training Program
625 19TH ST S
BIRMINGHAM, AL 35233
Jefferson County (205) 975-3756
MATTHEW GUILFORD LONG
Student in an Organized Health Care Education/Training Program
625 19TH ST S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-6007
AMANDA MARINELLO
Student in an Organized Health Care Education/Training Program
625 19TH ST S
BIRMINGHAM, AL 35233
Jefferson County (205) 975-7104
BENJAMIN ROWLAND MD
Student in an Organized Health Care Education/Training Program
625 19TH ST S
BIRMINGHAM, AL 35233
Jefferson County (205) 975-0208

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 Owen Clark's NPI number?

The NPI number for Owen Clark is 1356145080. It was assigned to this individual provider in the NPPES registry on April 2, 2025.

Where is Owen Clark located?

Owen Clark practices at 625 19th St S, Birmingham, AL 35233. The listed phone number is (205) 934-4696.

What is Owen Clark's specialty?

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

Is Owen Clark enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Owen Clark was last updated on April 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.