Denise S Clark, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS6040 Issued in FL

Practice address

1118 S Orange Ave
Suite 202
Orlando, FL 32806-1200

Phone

(321) 281-8400

Fax

(321) 281-8904

NPI assigned

Sep 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Primary Care Specialists, LLC

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1801053095
  NPD (past)

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203638400000",
    "number": "1174626535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 S ORANGE AVE",
            "address_2": "SUITE 202",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061200",
            "telephone_number": "321-281-8400",
            "fax_number": "321-281-8904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 S ORANGE AVE",
            "address_2": "SUITE 202",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061200",
            "telephone_number": "321-281-8400",
            "fax_number": "321-281-8904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DENISE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2008-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS6040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Callie Clark
• Cheryl A. Clark, M.D.
• Courtlynn Clark
• Daniel Eric Campbell Clark, PMHNP-BC
• Darwin K Clark, MD
• Elma Aseron Clark, CRNA
• Grace Catherine Clark, PHARMD, MPH
• Jan Ellen Clark
• Jenna Clark
• Jennifer Nicole Clark, ARNP, MSN

• Family Medicine Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.