Active NPI
Brian Allan Clark, LRT
- Home Health Certified Respiratory Therapist
- Midland, MI
National Provider Identifier
1144524851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Certified Respiratory Therapist
- License
- L1645896
- Practice address
- 2910 N Saginaw Rd
Midland, MI 48640-2634 - Phone
- (989) 486-3040
- Fax
- (989) 486-3770
- NPI assigned
- Jan 10, 2011
- Last updated
- Jun 14, 2011
- 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 |
|---|---|---|---|---|
| Home Health Certified Respiratory Therapist | 2278H0200X | L1645896 | MI | Primary |
Addresses
Primary practice location
2910 N Saginaw Rd
Midland, MI 48640-2634
Mailing address
2910 N Saginaw Rd
Midland, MI 48640-2634
Phone (989) 486-3040
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L1645896 | MI | MD | Home Health Certified Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308009600000",
"number": "1144524851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2910 N SAGINAW RD",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486402634",
"telephone_number": "989-486-3040",
"fax_number": "989-486-3770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2910 N SAGINAW RD",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486402634",
"telephone_number": "989-486-3040",
"fax_number": "989-486-3770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "BRIAN",
"middle_name": "ALLAN",
"name_prefix": "Mr.",
"credential": "LRT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-10",
"last_updated": "2011-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "2278H0200X",
"taxonomy_group": "",
"desc": "Respiratory Therapist, Certified, Home Health",
"state": "MI",
"license": "L1645896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.