Jacob Scott Clark, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1322 Issued in LA

Practice address

854C Kaliste Saloom Rd
Lafayette, LA 70508-4210

Phone

(337) 232-3353

Fax

(337) 232-9304

NPI assigned

May 5, 2006

Last updated

May 2, 2008By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clark Integrated Medical Clinics LLCGroup PAC ID 8022372598, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• MS PPO
• MS PPO C-SNP
• TX HMO D-SNP
• MS PPO D-SNP
• TX HMO

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/clark

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

• Clark Integrated Medical Clinics LLC

  dba Clark Integrated Medical Clinics

  • General Practice Physician
  • Lafayette, LA
  • NPI 1124529284

  Chiropractor

  Medicare reassignment Care Compare group NPD Authorized official
• Louisiana Brain Injury Specialists, LLC

  • Neurology Physician
  • Lafayette, LA
  • NPI 1912870924
  NPD Authorized official
• Clark Chiropractic, L.L.C.

  • Chiropractor
  • Lafayette, LA
  • NPI 1588799563
  Authorized official Same address or phone
• Pinhook Chiropractic Clinic

  • Chiropractor
  • Lafayette, LA
  • NPI 1215091855
  NPD (past)
• Alexandria Ophthalmic Associates, P.C.

  • Ophthalmology Physician
  • Alexandria, VA
  • NPI 1285958538
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209686400000",
    "number": "1003864620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854C KALISTE SALOOM RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705084210",
            "telephone_number": "337-232-3353",
            "fax_number": "337-232-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854C KALISTE SALOOM RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705084210",
            "telephone_number": "337-232-3353",
            "fax_number": "337-232-9304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JACOB",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2008-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clark Chiropractic, L.L.C.
• Clark Integrated Medical Clinics LLC (Clark Integrated Medical Clinics)
• Christina Marie Clark Mills, PHYSICAL THERAPIST
• Aja Clark
• Cassie Clark
• Robert D Clark, CRNA
• Roderick V. Clark, M.D.
• Ross Clark
• Andrew F. Clarke, M.D.
• Fran F Clarke, LCSW BCD

• Chiropractor in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Chiropractor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.