Active NPI
Shawn Clark, DO
- Surgery Physician
- Salem, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 34-012867
- Practice address
- 2094 E State St Ste a
Salem, OH 44460-4409 - Phone
- (330) 337-2868
- Fax
- (330) 337-2875
- NPI assigned
- Feb 28, 2014
- Last updated
- Nov 30, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0000000000000 | OH | |
| Surgery Physician | 208600000X | 34-012867 | OH | Primary |
Addresses
Primary practice location
2094 E State St Ste a
Salem, OH 44460-4409
Mailing address
2094 E State St Ste a
Salem, OH 44460-4409
Phone (330) 337-2868
Other practice location 1
1900 23rd St
Cuyahoga Falls, OH 44223-1404
Phone (330) 971-7225
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Shawn.Clark@salemregional.medicity.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Ohio University, College of Osteopathic Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2094 E State St
Suite a
Salem, OH 44460-4409
Phone (330) 337-2868
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.84 of 100
- Quality
- 69.69
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 28 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 15 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000000000000 | OH | MD | Surgery Physician |
| 34-012867 | OH | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SCH Professional Corporation | Internal Medicine | Current | Accepting new patients |
Locations
116 Carriage Dr
Columbiana, OH 44408
Phone (330) 482-3871
750 E Park Ave
Columbiana, OH 44408
Phone (330) 337-3332
38506 Saltwell Rd
Lisbon, OH 44432
Phone (330) 424-1404
2094 E State St
Salem, OH 44460
Phone (330) 332-1551
2094 E State St
Ste A
Salem, OH 44460
Phone (330) 337-2868
2525 Southeast Blvd
Salem, OH 44460
Phone (330) 332-7524
Interoperability endpoints
- shawn.clark@salemregional.medicity.net
Organizations & group practices 1
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.
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Salem Regional Medical Center
- General Acute Care Hospital
- Salem, OH
- NPI 1639131535
-
dba SRMC Ancillary Services
- Radiology Clinic/Center
- Calcutta, OH
- NPI 1750227377
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669766400000",
"number": "1073938973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2094 E STATE ST STE A",
"city": "SALEM",
"state": "OH",
"postal_code": "444604409",
"telephone_number": "330-337-2868",
"fax_number": "330-337-2875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2094 E STATE ST STE A",
"city": "SALEM",
"state": "OH",
"postal_code": "444604409",
"telephone_number": "330-337-2868",
"fax_number": "330-337-2875"
}
],
"practiceLocations": [
{
"address_1": "1900 23rd St",
"address_purpose": "LOCATION",
"city": "Cuyahoga Falls",
"state": "OH",
"postal_code": "442231404",
"country_code": "US",
"telephone_number": "330-971-7225",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLARK",
"first_name": "SHAWN",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-02-28",
"last_updated": "2022-11-30",
"certification_date": "2022-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "0000000000000",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OH",
"license": "34-012867",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Shawn.Clark@salemregional.medicity.net",
"affiliation": "N",
"address_1": "2094 E State St Ste A",
"city": "Salem",
"state": "OH",
"country_code": "US",
"postal_code": "444604409",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Salem, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.