Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Cory Douglas Clark, PA

Individual provider Physician Assistant · NPI 1932861473

Mr. Cory Douglas Clark, PA is a Physician Assistant in Cincinnati, Ohio. Qualified in 2021, 5 years ago. Practices with Vein Center of Cincinnati LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
5
Licensed in
OH
In the registry since
2021
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

7426 Beechmont Ave Unit 212
Cincinnati, OH 45255-4105
Phone: (513) 232-2400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 50.006996RX (OH)

Record details

NPI number1932861473
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 12, 2021
Last updated in NPPESJanuary 9, 2024
Certification dateJanuary 9, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Vein Center Of Cincinnati Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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