Jaymond Ryan Clark, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

16169 Issued in AR

Practice address

2100 Meadowlake Rd Ste 10
Conway, AR 72032-2569

Phone

(501) 513-3322

Fax

(501) 513-3065

NPI assigned

Mar 14, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Jay Clark Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• William C. Eriksen, PSC

  • Chiropractor
  • Radcliff, KY
  • NPI 1184700734
  NPD
• Greentree Health

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1295073294

  Chiropractor

  NPD (past)

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

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1023359155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MEADOWLAKE RD STE 10",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720322569",
            "telephone_number": "501-513-3322",
            "fax_number": "501-513-3065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MEADOWLAKE RD STE 10",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720322569",
            "telephone_number": "501-513-3322",
            "fax_number": "501-513-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JAYMOND",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-14",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12457",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "5441",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "16169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAY",
            "last_name": "CLARK",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Dema Clark, RECOVERY ASSISTANT
• Diana Drury Clark, CF-SLP
• Edgel Clark, RECOVERY ASSISTANT
• Emmett Don Clark Jr., PTA
• James T Clark Jr., M.D.
• John Nicholas Clark, D.D.S.
• Kelly L Clark, PTA
• Leslea Clark, M.S.CCC-SLP
• Mark L Clark, PHD
• Raymond H Clark, MD

• Chiropractor in Conway, AR
• Providers in Conway, AR by specialty
• Chiropractor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.