Individual provider Active NPI

Shawn Clark, DO

  • Surgery Physician
  • Salem, OH
National Provider Identifier
1073938973
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
34-012867 Issued in OH
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, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200622001440 OH Practitioner - General Surgery 9133410509 Reassigns benefits to 1 organization

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
SCH Professional CorporationGroup PAC ID 0941291868, 59 clinicians

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 100Reported as apm
Quality
69.69
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy28
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux15
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0000000000000OHMDSurgery Physician
34-012867OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SCH Professional Corporation Internal Medicine CurrentSince Aug 3, 2020 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.