William R Clark II

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD61117110 Issued in WA

Practice address

188 W Northern Lights Blvd
Suite 800
Anchorage, AK 99503-3902

Phone

(907) 276-2803

Fax

(907) 278-8052

NPI assigned

May 22, 2006

Last updated

Nov 11, 2021By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK, 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wclark566733@direct.peacehealth.org

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.

• Independence Healthcare PC

  • Medical Specialty Clinic/Center
  • Soldotna, AK
  • NPI 1891790184
  Medicare reassignment NPD
• Peacehealth

  dba Ketchikan Medical Center

  • Critical Access Hospital
  • Ketchikan, AK
  • NPI 1396705539
  Medicare reassignment NPD
• Peacehealth

  dba Ketchikan Medical Center

  • Diagnostic Radiology Physician
  • Ketchikan, AK
  • NPI 1801965736
  Medicare reassignment NPD
• Multicare Health System

  dba Multicare Neurological Surgery

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Alaska Medical Center

  • Ambulatory Surgical Clinic/Center
  • Anchorage, AK
  • NPI 1194198747
  NPD Authorized official
• Alaska Urological Institute PC (Pharmacy)

  dba AMS Pharmacy

  • Pharmacy
  • Anchorage, AK
  • NPI 1992278097
  NPD Authorized official
• Alaska Urological Institute PC

  dba Alaska Medical Specialties

  • Urology Physician
  • Anchorage, AK
  • NPI 1689716185
  Authorized official Same address or phone
• Independence Healthcare PC

  dba Corvus Neurology

  • Sleep Disorder Diagnostic Clinic/Center
  • Soldotna, AK
  • NPI 1649861576
  NPD
• Multicare Health System

  dba MultiCare Immediate Clinic

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1396297487
  NPD
• Multicare Health System

  dba MultiCare Deaconess Retail Pharmacy

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• RBS Evolution of Alaska LLC

  dba Peninsula Radiation Oncology Center

  • Radiation Oncology Physician
  • Anchorage, AK
  • NPI 1316280209
  NPD (past)

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1073567079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 W NORTHERN LIGHTS BLVD",
            "address_2": "SUITE 800",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033902",
            "telephone_number": "907-276-2803",
            "fax_number": "907-278-8052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 W NORTHERN LIGHTS BLVD",
            "address_2": "SUITE 800",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033902",
            "telephone_number": "907-276-2803",
            "fax_number": "907-278-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "MD61117110",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AK",
            "license": "AK1625",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD1625",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nina Clark, PSYD, LPC
• Patrick Clark
• Sharon R Clark, BC-HIS
• Tezlyn Samantha Clark
• Victoria Ann Clark, MS, NCC, CDC I
• Sheila Munro Clarson, PHD
• Phillip Ryan Clary
• Tatianna Clary, SLPA
• Andrew Clavelot
• Taryn Michelle Clavelot, PHARM.D.

• Urology Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Urology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.