Charles Francis Clark, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

14939 Issued in CO

Practice address

8300 W 38TH Ave
Wheat Ridge, CO 80033-6005

Phone

(303) 467-4000

Fax

(303) 467-4064

NPI assigned

Sep 14, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242000000000",
    "number": "1104921055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3518 KIRKWOOD PL",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803041938",
            "telephone_number": "303-442-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 W 38TH AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336005",
            "telephone_number": "303-467-4000",
            "fax_number": "303-467-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHARLES",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2009-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "14939",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "CO",
            "license": "14939",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "CO",
            "license": "14939",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01149392",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura C Ciancio, O.D.
• Amber Cibrian
• Charles Anthony Ciociola Jr.
• Gayle Ann Civish, PHD
• Amber Lee Clark, PHARMD
• Forrest Joshua Clark
• Michael Adam Clark
• Kerry Clarke, MD
• Sarah E Claus
• Clear Creek Family Practice

• Psychiatry Physician in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• Psychiatry Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; 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.