NPIMap

Organization Active NPI

Clark Clinic Inc

  • Internal Medicine Physician
  • Oxford, FL
National Provider Identifier
1134873011
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CLARK CLINIC INC
Practice address
10840 N US Highway 301
Oxford, FL 34484-3558
Phone
(352) 787-1600
NPI assigned
Feb 9, 2022
Last updated
Feb 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Authorized official

Name
Lowell F. ClarkNPI 1336103563
Title
Medical Director
Phone
(352) 793-2441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

10840 N US Highway 301
Oxford, FL 34484-3558

Mailing address

212 S Fla St
Bushnell, FL 33513-6703
Phone (352) 793-2441

National Provider Directory

National Provider Directory
Tax ID family
Clark Clinic Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644364800000",
    "number": "1134873011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 S FLA ST",
            "city": "BUSHNELL",
            "state": "FL",
            "postal_code": "335136703",
            "telephone_number": "352-793-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10840 N US HIGHWAY 301",
            "city": "OXFORD",
            "state": "FL",
            "postal_code": "344843558",
            "telephone_number": "352-787-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "LOWELL",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "352-793-2441"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.