DR. JULIANA JACKSON CLARK (NPI# 1982675344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982675344 |
| Entity Type | Individual |
| Full Name | DR. JULIANA JACKSON CLARK |
| Credential | M.D. |
| Practice Address |
2406 Blue Ridge Rd Suite 100 Raleigh NC 27607-6678 |
| Practice Telephone | 9197865001 |
| Practice Fax Number | 9197865051 |
| Mailing Telephone | 9197865001 |
| Mailing Fax Number | 9197865051 |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
200300622 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BLUECROSSBLUESHIELD | 138NX | 01 |
| NC | 89138NX | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306114897 | Juliana M Clark | Occupational Therapy Assistant | 1066 Old State Rd N, Norwalk, OH 44857-9372 | 2011-12-12 |
| 1487101648 | Juliana Clark | Peer Specialist | 10700 Sw Beaverton Hillsdale Hwy, Beaverton, OR 97005-3019 | 2016-09-06 |
| 1538587613 | Juliana R Clark | Nurse Practitioner | 1201 7th St Se, Decatur, AL 35601-3337 | 2014-04-04 |
| Street Address |
2406 BLUE RIDGE RD SUITE 100 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607-6678 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649260043 | Lori Moore Langdon | Pediatrics | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2005-10-26 |
| 1386209633 | Wakemed Specialists Group LLC | Clinic/Center | 2406 Blue Ridge Rd, Raleigh, NC 27607-6678 | 2019-05-02 |
| 1730656638 | Kushal Khimji | Pharmacist | 2406 Blue Ridge Rd, Raleigh, NC 27607-6678 | 2018-10-29 |
| 1225446800 | Courtney Yerxa | Genetic Counselor, MS | 2406 Blue Ridge Rd, Suite 200, Raleigh, NC 27607-6678 | 2014-07-28 |
| 1265848154 | Wake Specialty Physicians, LLC | Durable Medical Equipment & Medical Supplies | 2406 Blue Ridge Rd, Suite 190, Raleigh, NC 27607-6678 | 2014-07-11 |
| 1801207543 | Melinda Lee Beavers | Pediatrics | 2406 Blue Ridge Rd, Raleigh, NC 27607-6678 | 2014-05-15 |
| 1942625991 | Jamie Harding | Physician Assistant | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2014-02-27 |
| 1427493071 | Alison Lee Vurnakes | Pediatrics | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2013-05-08 |
| 1154663482 | Alyssa Ann Jenkins | Pediatrics | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2013-03-25 |
| 1225372246 | Duke University Affiliated Physicians, Inc | Obstetrics & Gynecology | 2406 Blue Ridge Rd, Suite 250, Raleigh, NC 27607-6678 | 2012-11-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093144 | Kyndra Lawson | Behavior Technician | 5121 Kingdom Way, Suite 100, Raleigh, NC 27607 | 2018-05-14 |
| 1578082905 | Margaret Roberts Bova | Dietitian, Registered | 4207 Lake Boone Trail, Suite 210, Raleigh, NC 27607 | 2017-09-18 |
| 1184141897 | Chricat Garrard | Nurse Practitioner | 4207 Lake Boone Trl Ste 200, Raleigh, NC 27607 | 2017-08-23 |
| 1487178620 | John Patrick Morton | Pharmacist | 2411 Landmark Dr, Raleigh, NC 27607 | 2017-07-31 |
| 1023538857 | Heather Margaret Mazzola | Audiologist | 7800 Lake Boone Trail, 100, Raleigh, NC 27607 | 2017-06-22 |
| 1790216984 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2411 Landmark Drive, Raleigh, NC 27607 | 2017-03-21 |
| 1558819516 | Corilin Nocito Meggitt | Nurse Practitioner | 4505 Fair Meadows Ln Ste 102, Raleigh, NC 27607 | 2016-09-19 |
| 1942757034 | Stacie Walker | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 311, Raleigh, NC 27607 | 2016-09-06 |
| 1831644533 | Alisa Smajlagic Howe | Nurse Practitioner | 4210 Lake Boone Trail, Rex Rehab & Nursing Center, Raleigh, NC 27607 | 2016-08-23 |
| 1235598632 | Yoseph Saleh | Dentist | 107 Minden Ln, Raleigh, NC 27607 | 2016-02-15 |
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| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740622166 | Sunshine Pediatric and Adolescent Care | Pediatrics | 1631 Midtown Pl Ste 107, Raleigh, NC 27609-1300 | 2013-07-26 |
| 1134265721 | Daniel Elmer Brown | Pediatrics | 2412 Ridge Rd, Raleigh, NC 27612-4759 | 2007-01-30 |
| 1023077211 | Faith Pediatrics and Adolescent Medicine Inc. | Pediatrics | 3350 Six Forks Rd, Raleigh, NC 27609-7233 | 2006-03-17 |
| 1477524999 | Mary Beth Ogle Helton | Pediatrics | 2605 Blue Ridge Road, Suite 100, Raleigh, NC 27607-6678 | 2006-02-01 |
| 1265868806 | Easter Seals Ucp North Carolina & Virginia | Pediatrics | 314 Chapanoke Rd, Raleigh, NC 27603-3400 | 2013-09-14 |
| 1174888093 | Lyndsay Isil Weyers | Pediatrics | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2012-07-06 |
| 1619286291 | Mari L. Emmet | Pediatrics | 2605 Blue Ridge Road, Suite 100, Raleigh, NC 27607-6475 | 2010-09-30 |
| 1386861268 | Maria Premilla Alexander | Pediatrics | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2007-04-20 |
| 1346313475 | Peter Joseph Morris | Pediatrics | 220 Swinburne Rd, Raleigh, NC 27610-1834 | 2006-11-16 |
| 1962466631 | Jeffers Mann & Artman Pediatric & Adolesent Medicine Pa | Pediatrics | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2006-04-12 |
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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.