PETER CLARK, MD, PC (NPI# 1790970937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790970937 |
| Entity Type | Organization |
| Organization Name | PETER CLARK, MD, PC |
| Practice Address |
220 W South St Groton NY 13073-1237 |
| Practice Telephone | 6078983341 |
| Practice Fax Number | 6078983982 |
| Mailing Fax Number | 6078983982 |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2007-09-11 |
| Authorized Official Name | DR. PETER CLARK (PRESIDENT) |
| Authorized Official Telephone | 6078983341 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 181768 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01314507 | 05 |
| Street Address |
220 W SOUTH ST |
| City | GROTON |
| State | NY |
| Zip Code | 13073-1237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275518839 | Peter David Clark | Family Medicine | 220 W South St, Groton, NY 13073-1237 | 2005-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245514157 | Lorie Ann Pitcher | Registered Nurse | 400 Peru Rd, Groton, NY 13073 | 2011-10-11 |
| 1407085475 | Alberta Rae Thompson | Licensed Practical Nurse | 424 Smith Rd, Groton, NY 13073 | 2009-07-10 |
| 1306958087 | Sufdar Ali | Dentist | 119 W South St, Groton, NY 13073 | 2006-08-31 |
| 1821042847 | Groton Community Health Care Center Inc | Case Management | 120 Sykes Street, Groton, NY 13073 | 2006-05-22 |
| 1427037159 | Ahmad M Mehdi | Family Medicine | 100 Sykes St, Groton, NY 13073 | 2006-01-11 |
| 1760437362 | Groton Community Health Care Center Inc | Assisted Living Facility | 120 Sykes Street, Groton, NY 13073 | 2006-05-23 |
| 1477508083 | Groton Community Health Care Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 120 Sykes Street, Groton, NY 13073 | 2006-05-23 |
| 1942360227 | Princess Fawn Butts | Licensed Practical Nurse | 303 W Cortland St, Groton, NY 13073-1009 | 2006-12-09 |
| 1407119449 | Susan Diane Mcandrews | Licensed Practical Nurse | 405 W Cortland St, Box 147, Groton, NY 13073-1011 | 2012-06-22 |
| 1417128521 | Kathryn Baker | Registered Nurse | 107 Church St, Groton, NY 13073-1103 | 2008-03-17 |
| Find all providers in zip 13073 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780197715 | Yvonne J Sinclair | Family Medicine | 65 Merlino Dr, Groton, CT 06340-3149 | 2017-11-13 |
| 1982045969 | Jonathan Casey Brown | Family Medicine | 395 Hazelnut Hill Rd, Groton, CT 06340-3208 | 2013-07-08 |
| 1336434430 | Manju Mahajan | Family Medicine | 788 Boston Rd, Groton, MA 01450-2056 | 2011-06-16 |
| 1306031976 | Avera St Luke's | Family Medicine | 8 E Us Highway 12, Groton, SD 57445-2176 | 2007-09-07 |
| 1427037159 | Ahmad M Mehdi | Family Medicine | 100 Sykes St, Groton, NY 13073 | 2006-01-11 |
| 1558345918 | John Christopher Daniel | Family Medicine | Trout Ave Bldg 141, Naval Submarine Medical Research Laboratory, Groton, CT 06349-5900 | 2005-11-30 |
| 1114918828 | Paul David Seeman | Family Medicine | Route 12 Bldg 449 Professional Affairs, Naval Ambulatory Care Center, Groton, CT 06349-5600 | 2005-11-02 |
| 1710978739 | Joel Walter Larcombe | Family Medicine | Route 12 Bldg 449, Naval Ambulatory Care Center Attn Professional Affairs, Groton, CT 06349-5600 | 2005-10-31 |
| 1588984264 | Tisha N. Dickey | Family Medicine | 1 Forge Village Rd, Groton, MA 01450-2047 | 2010-06-04 |
| 1972730380 | William A Boller IIi | Family Medicine | 1 Wahoo Ave, Groton, CT 06349-2324 | 2009-06-12 |
| Find all providers in GROTON | ||||
Please comment or provide details below to improve the information on PETER CLARK, MD, PC.
| 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.