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Peggy D Clark , SLP

Speech-Language Pathologist β€’ Bangor, ME

Active NPI 1821094897 Individual Practitioner Female Practitioner
Practice location in NPPES

6 Telcom Dr
Bangor, ME 044013072

Call 2079412850 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

6 Telcom Dr

Bangor, ME 044013072

Telephone 2079412850
Fax 2079412852
Organization at the Same NPPES Address or Phone
Penobscot Community Health Center Facility NPI 1285685628

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2005

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Bangor and Maine

47 active clinicians are listed under Speech-Language Pathologist with a practice address in Bangor, ME (1,168 in Maine).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Bangor

0% of these 47 clinicians have the CMS telehealth indicator.

0% of these 47 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-06-15
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

License # reported to NPPES ME SP958

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Maine State Medical Licensing Board.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
704575468A (GA)
Other Identifier Amerigroup
10037581 (GA)
Other Identifier Wellcare
344119 (GA)

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

5 listed
NPI 1922538875

Doctor of Audiology

NPI 1477080455

Doctor of Audiology

NPI 1699067553

Doctor of Audiology

NPI 1790712396

Doctor of Audiology

NPI 1871106047

Doctor of Audiology

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸ“
Updated Practice Location May 04, 2021

Registered at 6 TELCOM DR, BANGOR, ME 044013072 (Tel: 2079412850)

βœ…
NPI Profile Active August 19, 2013

NPI status registered as active in NPPES database

πŸ“
Business Mailing Address (Initial Record) August 19, 2013

Registered at PO BOX 1599, BANGOR, ME 044021599 (Tel: 2079455247)

πŸ“
Practice Location (Initial Record) August 19, 2013

Registered at 992 UNION ST, BANGOR, ME 044013057 (Tel: 2079412850)

πŸ‘€
Provider Name / Credentials (Initial Record) August 19, 2013

Recorded as PEGGY CLARK, SLP

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 19, 2013

Speech-Language Pathologist (license number reported to NPPES: ME SP958)

🟒
Initial NPI Registration & Enumeration June 24, 2005

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1821094897
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 24, 2005
Last Update: June 15, 2021
Sole Proprietor: No

Mailing Address

Po Box 1599

Bangor, ME 044021599

Phone: 2079455247

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.