DR. WILLIAM GILMER CLARK MD
NPI 1528047503
Family Medicine in Wake Forest, NC

NPI Status: Active since January 10, 2006

Contact Information

2115 S MAIN ST
WAKE FOREST, NC
ZIP 27587
Phone: (919) 570-2000
Fax: (919) 570-2001

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  • Individual
  • Male
  • Years of Experience 48
  • Family Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About WILLIAM CLARK

This page provides the complete NPI Profile along with additional information for William Clark, a primary care provider established in Wake Forest, North Carolina with a medical specialization in Family Medicine and more than 48 years of experience. He graduated from University Of North Carolina At Chapel Hill School Of Medicine in 1978. The healthcare provider is registered in the NPI registry with number 1528047503 assigned on January 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 24323 (NC). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI
1528047503
Provider Name
DR. WILLIAM GILMER CLARK MD
Gender
Male
Entity Type
Individual
Location Address
2115 S MAIN ST WAKE FOREST, NC 27587
Location Phone
(919) 570-2000
Location Fax
(919) 570-2001
Mailing Address
12418 DUNARD ST RALEIGH, NC 27614
Mailing Phone
(919) 554-8868
Medical School Name
UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF MEDICINE
Graduation Year
1978
Is Sole Proprietor?
No
Enumeration Date
01-10-2006
Last Update Date
10-25-2020
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A primary care provider (PCP) like William Clark sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
24323
License State
NC
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Advantage Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
  • Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Bronze Standard | Nationwide Doctors - PPO
  • Blue Advantage Gold Premier | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Gold Standard | Nationwide Doctors - PPO
  • Blue Advantage Silver Choice | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
  • Blue Advantage Silver Standard | Nationwide Doctors - PPO
  • Blue Care Bronze Standard | Statewide Doctors - HMO
  • Blue Care Gold Standard | Statewide Doctors - HMO
  • Blue Care Silver Standard | Statewide Doctors - HMO
  • Blue Home Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | with Novant Health - EPO
  • Blue Home Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | with UNC Health Alliance - EPO
  • Blue Home Bronze Complete | $60 PCP | $20 Tier 1 Rx | with UNC Health Alliance - EPO
  • Blue Home Bronze Standard | with Novant Health - EPO
  • Blue Home Bronze Standard | with UNC Health Alliance - EPO
  • Blue Home Gold Premier | 3 Free PCP | $10 Tier 1 Rx | with Novant Health - EPO
  • Blue Home Gold Premier | 3 Free PCP | $10 Tier 1 Rx | with UNC Health Alliance - EPO
  • Blue Home Gold Standard | with Novant Health - EPO
  • Blue Home Gold Standard | with UNC Health Alliance - EPO
  • Bronze First 7500 $25 Generic Drugs - HMO
  • Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
  • Core Gold 1500 $10 Generic Drugs - HMO
  • Core Gold 1500 $10 Generic Drugs Adult Vision & Fitness - HMO
  • Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
  • Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
  • Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Gold 1500 $15 Generic Drugs - HMO
  • Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
  • HDHP Preventive Silver 5500 $0 Select Drugs - HMO
  • Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
  • Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
  • Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Low Premium Silver 6000 $3 Generic Drugs - HMO
  • Low Premium Silver 6000 $3 Generic Drugs Adult Vision & Fitness - HMO
  • Silver 5000 $20 Generic Drugs - HMO
  • Silver 5000 $20 Generic Drugs Adult Vision & Fitness - HMO
  • Connect Bronze 5500 Indiv Med Deductible - HMO
  • Connect Bronze 6500 Indiv Med Deductible - HMO
  • Connect Bronze CMS Standard - HMO
  • Connect Gold CMS Standard - HMO
  • Connect Silver 3500 Indiv Med Deductible - HMO
  • Connect Silver 4400 Indiv Med Deductible - HMO
  • Connect Silver CMS Standard - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

William Clark is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

William Clark is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 2365679214

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20131220000981

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    7 DME suppliers used 20 Medicare Claims 45 Services Paid

  • DME-Other DME (DE001N)

    Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

    4 DME suppliers used 11 Medicare Claims 11 Services Paid

  • DME-Hospital Beds (DB000N)

    Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)

    2 DME suppliers used 20 Medicare Claims 20 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of influenza virus vaccine

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

This service was performed 27 times for 27 patients

Administration of pneumococcal vaccine

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

This service was performed 22 times for 22 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

This service was performed 129 times for 129 patients

Automated urinalysis test

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

This service was performed 21 times for 19 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 31 times for 24 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 386 times for 167 patients

Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage

The quadrivalent inactivated influenza vaccine is a shot given to protect against four strains of the flu virus. This 0.5 ml dosage helps your body develop immunity to the virus. It's an important step in preventing flu-related complications.

This service was performed 22 times for 22 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 17 times for 17 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

This service was performed 15 times for 15 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

This service was performed 19 times for 18 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $20.97 for a new patient copayment and $23.98 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 27587 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $83.9
  • Minimum New Patient Price $54.12
  • Maximum New Patient Price $165.09
  • Average New Patient Copayment $20.97
  • Minimum New Patient Copayment $13.53
  • Maximum New Patient Copayment $41.27

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $95.94
  • Minimum Established Patient Price $17.21
  • Maximum Established Patient Price $134.61
  • Average Established Patient Copayment $23.98
  • Minimum Established Patient Copayment $4.3
  • Maximum Established Patient Copayment $33.65

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Breast Cancer Screening 4% 109
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Chronic Care and Preventative Care Management for Empaneled PatientsYesN/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
Colorectal Cancer Screening 88% 84
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
e-Prescribing 99% 158
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Implementation of medication management practice improvementsYesN/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Medication Reconciliation 99% 379
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education 14% 1108
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Pneumococcal Vaccination Status for Older Adults 80% 102
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 32% 111
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Provide Patient Access 71% 1108
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Screening for Osteoporosis for Women Aged 65-85 Years of Age 77% 47
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
Secure Messaging 16% 1108
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Use of decision support and standardized treatment protocolsYesN/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1528047503
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2548041450
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 4 + 8 + 0 + 4 + 1 + 4 + 5 + 0 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1528047503 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 4 providers are registered at the same or nearby location.

MRS. SHEILA MARIE GALLAGHER-WHITLOCK PT

Physical Therapist

(Orthopedic)

2115 S MAIN ST
WAKE FOREST, NC
ZIP 27587

(919) 570-5755

WAKE FOREST URGENT CARE, PLLC

Clinic/Center

2115 S MAIN ST
SUITE A
WAKE FOREST, NC
ZIP 27587

(919) 570-2000

NATHALIE MONTANO

Physical Therapist

2115 S MAIN ST
WAKE FOREST, NC
ZIP 27587

(919) 570-5755

MAINSTREET AND KIDSSTREET OF NORTH CAROLINA PLLC

Clinic/Center

(Urgent Care)

2115 S MAIN ST
WAKE FOREST, NC
ZIP 27587

(919) 229-4833

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1528047503, enumerated as an "individual" on January 10, 2006.

The provider is located at 2115 S MAIN ST WAKE FOREST, NC 27587 and the phone number is (919) 570-2000.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of NC, CareSource and. Please consult your insurance carrier or call the provider to verify.