Active NPI
Ewell Clarke, MD
- Diagnostic Radiology Physician
- San Antonio, TX
National Provider Identifier
1073620050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- E8395
- Practice address
- 4502 Medical Dr
San Antonio, TX 78229-4402 - Phone
- (210) 257-1400
- NPI assigned
- Aug 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | E8395 | TX | Primary |
Addresses
Primary practice location
4502 Medical Dr
San Antonio, TX 78229-4402
Mailing address
Uthscsa, Uthscsa, Dept. of Radiology
7703 Floyd Curl Drive, RM 636F
San Antonio, TX 78229
Phone (210) 358-4000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 117466603 | Other | TX | CIDC |
| 117466602 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211846400000",
"number": "1073620050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "UTHSCSA, UTHSCSA, DEPT. OF RADIOLOGY",
"address_2": "7703 FLOYD CURL DRIVE, RM 636F",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78229",
"telephone_number": "210-358-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4502 MEDICAL DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782294402",
"telephone_number": "210-257-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARKE",
"first_name": "EWELL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-24",
"last_updated": "2008-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TX",
"license": "E8395",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIDC",
"identifier": "117466603",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "117466602",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.