BRADLEY W. CLARK MD – NPI #1639431307
Nuclear Medicine

A nuclear medicine physician who specializes in nuclear cardiology.

Health Care Provider Taxonomy Code for Nuclear Medicine

BRADLEY CLARK is a physician located in CLEMMONS, NC. NPPES has assigned the NPI number 1639431307 to BRADLEY CLARK on June 08, 2012. It is a Type-1 NPI, indicating this NPI number is associated with an individual. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207UN0901X from the Health Care Provider Taxonomy code set, which is classified as Nuclear Medicine, specializing in Nuclear Cardiology

The NPI profile was previously updated about 5 years ago on Feb 18, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BRADLEY CLARK below.

NPI Profile for
BRADLEY W. CLARK

NPI Number
1639431307
Enumeration Date

(more than 14 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
BRADLEY W. CLARK
Credentials
MD
Primary location
7114 VILLAGE MEDICAL CIR
CLEMMONS, NC 27012-8004
Phone: (336) 893-2440 Fax: (336) 893-2470
1 Other location(s):
186 Kimel Park Dr
Winston Salem, NC 27103
Phone: (336) 277-2000
Fax: (336) 277-2050
Mailing address
PO BOX 751803
CHARLOTTE, NC 28275-1803
Phone: (336) 277-2000 Fax: (336) 277-2050
Sole Proprietor
No
Updated
Certification Date
Feb 18, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207UN0901X
- Nuclear Medicine / Nuclear Cardiology (Primary)		 NC 2015-00428
207RC0000X
- Internal Medicine / Cardiovascular Disease		 NC 2015-00428
207R00000X
- Internal Medicine		 NC 2015-00428

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

View All Endpoint(s)
Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
Affiliation
N
Endpoint Location
186 KIMEL PARK DR,
WINSTON SALEM, NC 77025-1669
Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
Affiliation
N
Endpoint Location
7114 VILLAGE MEDICAL CIR,
CLEMMONS, NC 77025-1669

Additional Information

Education
UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE - Graduated 2012
Accepts Medicare
This provider accepts Medicare-approved amount as payment in full. The Medicare-approved amount is the total the provider can be paid. When a provider accepts the Medicare-approved amount as payment, you won't be billed for more than the Medicare deductible & coinsureance.
Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency
  • Order Power Mobility Devices
Affiliations
BRADLEY CLARK is affiliated with the following medical group(s):
  • HOSPITAL
    • HUGH CHATHAM MEMORIAL HOSPITAL
      180 PARKWOOD DR
      ELKIN, NC 28621
    • NORTH CAROLINA BAPTIST HOSPITAL
      MEDICAL CENTER BOULEVARD
      WINSTON-SALEM, NC 27157
    • NORTHERN REGIONAL HOSPITAL
      830 ROCKFORD ST
      MOUNT AIRY, NC 27030
    • NOVANT HEALTH FORSYTH MEDICAL CENTER
      3333 SILAS CREEK PARKWAY
      WINSTON-SALEM, NC 27103
    • NOVANT HEALTH THOMASVILLE MEDICAL CENTER
      207 OLD LEXINGTON RD BOX 789
      THOMASVILLE, NC 27360

Why is my NPI data (personal information) being displayed publicly?
If you have an active NPI profile, your profile is required to be disclosed according to the FOIA and eFOIA. HIPAA also requires covered providers to share their NPI with other providers, health plans, clearinghouses and any entity that may need it for billing purposes.

How do I correct or change the NPI data displayed here?
At any time, providers can make changes to their NPI profile at NPPES. Login to NPPES to make changes online or call (800) 465-3203 for assistance. Changes made at NPPES will be reflected on this web site within a few days.

Can I hide my NPI profile from the public?
Unfortunately, No. The NPPES discloses health care provider data under the Freedom of Information Act to the public, which means anyone may request such information directly from the National Plan & Provider Enumeration System. See the complete CMS Data Dissemination Notice here.