NPIMap

Individual provider Active NPI

Donald Lester Clark, MD

  • Family Medicine Physician
  • Dayton, OH
National Provider Identifier
1154313369
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-120123 Issued in OH
Practice address
725 University Blvd
Dayton, OH 45435-0001
Phone
(937) 245-7200
Fax
(937) 245-7922
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-114287 IL
Family Medicine Physician 207Q00000X 35-120123 OH Primary

Addresses

Primary practice location

725 University Blvd
Dayton, OH 45435-0001

Mailing address

725 University Blvd
Dayton, OH 45435-0001
Phone (937) 245-7100

Other identifiers 2

IdentifierTypeStateIssuer
036114287MedicaidIL
0073290MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121110000093 OH Practitioner - Family Practice 6103859202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trihealth G LLCGroup PAC ID 0749222651, 294 clinicians

Practice addresses (Care Compare)

10675 Loveland Madeira Rd
Suite a
Loveland, OH 45140-8965
Phone (513) 774-8220

Hospital & facility affiliations

  • American Mercy Home Care, LLC Home health agency, Cincinnati, OH, CCN 367167
  • Bethesda North Hospital, Cincinnati, OH, CCN 360179
  • Good Samaritan Hospital Hospital, Cincinnati, OH, CCN 360134
  • Christ Hospital Hospital, Cincinnati, OH, CCN 360163

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-114287ILMDFamily Medicine Physician
35-120123OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trihealth G LLC Family Medicine CurrentSince Mar 1, 2016 Accepting new patients
Trihealth G, LLC CurrentSince Mar 1, 2016 Accepting new patients
Winter Haven Hospital Inc PastSince Nov 24, 2019 Accepting new patients
Wright State Physicians Inc Past Accepting new patients
PC Associates, LLC Family Medicine Past Accepting new patients
University Health Physicians Family Medicine Past Accepting new patients
Trihealth G LLC Family Medicine Past Accepting new patients

Locations

2001 Anderson Ferry Rd
Cincinnati, OH 45238
Phone (513) 922-1200

9070 Winton Rd
Cincinnati, OH 45231
Phone (513) 246-2750

10675 Loveland Madeira Rd
#A
Loveland, OH 45140
Phone (513) 774-8220

4685 Forest Ave
Ste C
Norwood, OH 45212
Phone (513) 246-7796

Interoperability endpoints

  • Direct secure messaging: dclark229864@direct.trihealth.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1154313369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 UNIVERSITY BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454350001",
            "telephone_number": "937-245-7100",
            "fax_number": "937-245-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 UNIVERSITY BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454350001",
            "telephone_number": "937-245-7200",
            "fax_number": "937-245-7922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DONALD",
        "middle_name": "LESTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2013-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-114287",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-120123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036114287",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0073290",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.