CMS-1500 Box 24J / 33a • NPI
1992890354
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
103G00000X
Licensed & Credentialed Clinical Neuropsychologist
Box 32 Service Location & ZIP+4
JOHN UMSTEAD HOSPITAL, 1003 12TH STREET, BUTNER, NC, 27509
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1992890354 (LAURA M. CLARK, Ph.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1992890354 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | LAURA M. CLARK, Ph.D. |
| Plain-English Specialty | Licensed & Credentialed Clinical Neuropsychologist NUCC Code: 103G00000X (Clinical Neuropsychologist) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | JOHN UMSTEAD HOSPITAL, 1003 12TH STREET, BUTNER, NC, 27509 |
| Practice Telephone / Fax | Tel: (919) 575-7082 | Fax: (919) 575-7395 |
| Administrative Mailing Address | JOHN UMSTEAD HOSPITAL, BUTNER, NC, 27509 |
| Enumeration & Last Sync | Enumerated: 2006-10-03 | CMS Record Updated: 2025-09-11 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (103G00000X)
What Does Taxonomy Code 103G00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103G00000X translates to:
"Licensed & Credentialed Clinical Neuropsychologist"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (LAURA M. CLARK, Ph.D.)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
103G00000X — Clinical NeuropsychologistPlain English: Licensed & Credentialed Clinical Neuropsychologist | State: NC | License: 1848 | Primary: Yes (Primary) |
103TC0700X — Psychologist, ClinicalPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical | State: NC | License: 1848 | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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