Bradly D Clark, MD

Primary specialty

Anatomic Pathology PhysicianTaxonomy code 207ZP0101X

License

MD47889 Issued in TN

Practice address

3495 Hacks Cross Rd
Memphis, TN 38125-8803

Phone

(901) 526-7444

Fax

(901) 271-2618

NPI assigned

Jan 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, WA2 enrollments

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 2

Specialty

Pathology

Education

Howard University College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4

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.

• Optum Care Washington PLLC

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1831186766
  Medicare reassignment Care Compare group NPD
• Ameripath Indianapolis PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Memphis, TN
  • NPI 1013759059
  Medicare reassignment NPD
• Gastrointestinal Associates of Northeast Tennessee, PC

  • Gastroenterology Physician
  • Johnson City, TN
  • NPI 1578529632
  Medicare reassignment NPD
• The Polyclinic PLLC

  • Audiologist
  • Seattle, WA
  • NPI 1174594634
  Medicare reassignment NPD
• Poplar Healthcare, PLLC

  • Specialist
  • Memphis, TN
  • NPI 1346271251
  Medicare reassignment
• Ameripath Indianapolis PC

  • Clinical Medical Laboratory
  • Memphis, TN
  • NPI 1639911688
  NPD
• Ameripath Indianapolis PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Rolla, MO
  • NPI 1053102004
  NPD
• Optum Care Washington PLLC

  • Durable Medical Equipment & Medical Supplies
  • Marysville, WA
  • NPI 1194428425
  NPD
• The Polyclinic

  • Ambulatory Surgical Clinic/Center
  • Seattle, WA
  • NPI 1073944039
  NPD
• The Polyclinic PLLC

  • Durable Medical Equipment & Medical Supplies
  • Tacoma, WA
  • NPI 1831411487
  NPD
• Howard John Simon MD PC

  • Diagnostic Radiology Physician
  • New York, NY
  • NPI 1932768934
  NPD (past)
• MSK-Guttman Diagnostic Center

  • Diagnostic Radiology Physician
  • New York, NY
  • NPI 1629049184
  NPD (past)

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1023098928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 HACKS CROSS RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258803",
            "telephone_number": "901-526-7444",
            "fax_number": "901-271-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 HACKS CROSS RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258803",
            "telephone_number": "901-526-7444",
            "fax_number": "901-271-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BRADLY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "NY",
            "license": "231963",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "TN",
            "license": "MD47889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dona Lyn Clarin, FNP
• Lisa Clark Askew
• Clark Mental Health Services
• Alisha Kaye Clark, RN, CPNP-AC
• Ariel Clark
• Camaya Alisha Clark
• Carolyn D Clark
• Christina Clark
• Cora Clark
• Deborah Clark, LICENSED PTA

• Anatomic Pathology Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Anatomic Pathology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; 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.