DR. DEIRDRE V CLARK DC ND CHT CCRA NPI 1053615989

NPI Information

  • NPI: 1053615989
  • Provider Name: DR. DEIRDRE V CLARK, DC, ND, CHT, CCRA
  • Classification: Chiropractor - 111N00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 10926 DAVID TAYLOR DR STE 120
    CHARLOTTE, NC
    ZIP 28262
  • Phone: (704) 266-3250

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NPI Details

DR. Deirdre V Clark, DC, ND, CHT, CCRA is a chiropractor in Charlotte, NC. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. DR. Deirdre V Clark, DC, ND, CHT, CCRA NPI is 1053615989. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

10926 DAVID TAYLOR DR STE 120
CHARLOTTE, NC
ZIP 28262-042
Phone: (704) 266-3250

The NPI 1053615989 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Chiropractic manipulative treatment, 3-4 spinal regions (HCPCS:98941)

The enumeration date for this NPI number is 1/6/2011 and was last updated on 8/27/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractor5172NORTH CAROLINAYes
21744R1102XSpecialistResearch StudyNo
3175F00000XNaturopathNo
4171M00000XCase Manager/Care CoordinatorNo
5111NI0013XChiropractorIndependent Medical Examiner5171NORTH CAROLINANo
6111NI0013XChiropractorIndependent Medical Examiner5172NORTH CAROLINANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15172OTHERNORTH CAROLINACHIROPRACTIC LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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