Edgar H Clark, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G34799 Issued in CA

Practice address

6585 Clark Rd
Suite 360
Paradise, CA 95969-3500

Phone

(530) 877-8855

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Loma Linda University School of Medicine, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Visalia Family Practice Medical GroupGroup PAC ID 9830139179, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaweah Health Medical Center Hospital, Visalia, CA, CCN 050057

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EAFIAA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Visalia Family Practice Medical Group

  • Family Medicine Physician
  • Visalia, CA
  • NPI 1073681730
  Medicare reassignment Care Compare group NPD
• Paradise Medical Group, Inc.

  • Family Medicine Physician
  • Paradise, CA
  • NPI 1235111006
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kaweah Delta Health Care District

  • General Acute Care Hospital
  • Visalia, CA
  • NPI 1588663769
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003847872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7056B SKYWAY",
            "city": "PARADISE",
            "state": "CA",
            "postal_code": "959693900",
            "telephone_number": "530-872-6650",
            "fax_number": "530-872-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6585 CLARK RD",
            "address_2": "SUITE 360",
            "city": "PARADISE",
            "state": "CA",
            "postal_code": "959693500",
            "telephone_number": "530-877-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "EDGAR",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G34799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ01920Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Children'S Community Charter School
• Joelle Susanne Chinnock, RD
• Mark Edward Chorjel
• Loren Christopher, MFT
• Carly Ann Clapham
• Maria Clark
• Tina Marie Clark
• William Joseph Coady, MFT
• Michael Frances Coates
• Cobblestone Pharmacy

• Family Medicine Physician in Paradise, CA
• Providers in Paradise, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.