LOWELL CLARK (NPI# 1023085966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023085966 |
| Entity Type | Individual |
| Full Name | LOWELL CLARK |
| Credential | MD |
| Practice Address |
777 Hemlock St Msc 83 Macon GA 31201-2102 |
| Practice Telephone | 4786337140 |
| Mailing Telephone | 4786337140 |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2012-09-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 017444 | GA | Allopathic & Osteopathic Physicians |
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
017444 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000138982C | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942482369 | Lowell Erskine Clark | Family Medicine | 4225 Se Centerboard Ln, Stuart, FL 34997-6165 | 2007-11-27 |
| 1336103563 | Lowell F. Clark | Internal Medicine | 212 S Florida St, Bushnell, FL 33513-6703 | 2006-04-14 |
| Street Address |
777 HEMLOCK ST MSC 83 |
| City | MACON |
| State | GA |
| Zip Code | 31201-2102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467452375 | Sandra E Moore | Pediatrics | 777 Hemlock St, Msc 83, Macon, GA 31201-2102 | 2005-07-21 |
| 1740881796 | Daquanda Arnett | Registered Nurse | 777 Hemlock St, Macon, GA 31201-2102 | 2020-11-05 |
| 1538770383 | Laquanna Foster | Nurse Practitioner | 777 Hemlock St, Macon, GA 31201-2102 | 2020-08-14 |
| 1669081113 | Sabrina L. Singleton | Anesthesiologist Assistant | 777 Hemlock St, Macon, GA 31201-2102 | 2020-07-29 |
| 1528686003 | Jonathan Michael Clopton | Nurse Practitioner | 777 Hemlock St, Macon, GA 31201-2102 | 2020-07-10 |
| 1194348623 | Samay Bhushan | Student in an Organized Health Care Education/Training Program | 777 Hemlock St, Macon, GA 31201-2102 | 2020-05-19 |
| 1184247785 | Andrew Tyler Barnes | Student in an Organized Health Care Education/Training Program | 777 Hemlock St, Macon, GA 31201-2102 | 2020-05-19 |
| 1922627108 | Gwenda Faye Canady | Registered Nurse | 777 Hemlock St, Macon, GA 31201-2102 | 2020-04-08 |
| 1376172536 | Hannah Batten | Student in an Organized Health Care Education/Training Program | 777 Hemlock St, Macon, GA 31201-2102 | 2020-04-08 |
| 1225667587 | Michael T Stevens | Student in an Organized Health Care Education/Training Program | 777 Hemlock St, Macon, GA 31201-2102 | 2020-04-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639666340 | Yasameen Emad Muzahim | Internal Medicine | 777 Hemlock Street, Msc 165, Macon, GA 31201 | 2018-04-18 |
| 1952819419 | Putnam Dialysis LLC | Clinic/Center | 657 Hemlock Street, Suite 200, Macon, GA 31201 | 2018-01-18 |
| 1730604331 | Graham Arthur Mercier | Surgery | 169 Ashley Ave., Room 202 Main Hospital Msc 333, Charleston, SC 31201 | 2017-08-04 |
| 1376075705 | Diamond Jude | Internal Medicine | 777 Hemlock Street Msc #104, Macon, GA 31201 | 2017-04-03 |
| 1174055263 | Carol Roobin Bashuk | Hearing Instrument Specialist | 634 First Street, Macon, GA 31201 | 2017-03-29 |
| 1144752411 | Hubert Pare | Student in an Organized Health Care Education/Training Program | 777 Hemlock Street, Msc# 165, Macon, GA 31201 | 2017-03-28 |
| 1548613789 | Michael Daugherty | Counselor | 1873 Hardeman Ave, Suite 1, Macon, GA 31201 | 2016-07-22 |
| 1316317993 | 4front Healthcare of Middle Georgia, LLC | Hospice Care, Community Based | 682 1st St, Macon, GA 31201 | 2015-09-25 |
| 1881073054 | Andrew Lee Drahos | Surgery | 777 Hemlock St # 140, Macon, GA 31201 | 2015-05-21 |
| 1720474158 | April Nicole Colley | Nurse Practitioner | 1014 Forsyth Street, Macon, GA 31201 | 2015-04-13 |
| Find all providers in zip 31201 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184980567 | Meral M Patel | Pediatrics | 777 Hemlock St # 130, Macon, GA 31201-2102 | 2012-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275000358 | Spring Heather Ou-tim | Pediatrics | 5461 Meridian Marks Rd Ste 540, Atlanta, GA 30342-3283 | 2018-10-26 |
| 1477796951 | Geoffrey Edward Mickells | Pediatrics | 5901-b Peachtree Dunwoody Rd, Suite B-420, Atlanta, GA 30328-7156 | 2009-04-13 |
| 1306955356 | Renuka Mehta | Pediatrics | Mcg 1120 15th St, Augusta, GA 30912-0004 | 2006-08-30 |
| 1750351326 | Richard J Cartie | Pediatrics | 3675 J Dewey Gray Cir, Suite 300, Augusta, GA 30909-1868 | 2006-01-25 |
| 1629064134 | Samuel B. Edelman | Pediatrics | 710 Center Street, Columbus, GA 31901 | 2005-09-21 |
| 1225455793 | Lisa Lima | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-1020 | 2014-03-23 |
| 1205270543 | Ashley Dodd Freeman | Pediatrics | 1120 15th St, Augusta, GA 30912-6805 | 2013-04-17 |
| 1265775159 | Neelima Krishnapriya Marupudi | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2013-03-29 |
| 1114215431 | Asaad G Beshish | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-5000 | 2011-07-20 |
| 1225325384 | Smitha Rajan Mathew | Pediatrics | 1120 15th St, Augusta, GA 30912-3957 | 2011-07-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.