Richard Clark

Primary specialty

OptometristTaxonomy code 152W00000X

License

1096 Issued in MS

Practice address

202 E Railroad St
Long Beach, MS 39560-4627

Phone

(228) 686-2020

NPI assigned

Apr 9, 2024

Last updated

Aug 6, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2024

Medicare assignment

May accept Medicare assignment

Group practices

Long Beach Precision Vision LLCGroup PAC ID 7719251743, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Long Beach Precision Vision LLC

  dba Precision Vision

  • Optometrist
  • Long Beach, MS
  • NPI 1750813010
  Medicare reassignment Care Compare group NPD
• Max M Edrington Optometrist PA

  • Optometrist
  • Long Beach, MS
  • NPI 1720249279
  NPD (past)

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

{
    "created_epoch": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1184477085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5121 MITCHELL RD",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395603201",
            "telephone_number": "228-229-6875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E RAILROAD ST",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395604627",
            "telephone_number": "228-686-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "1096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Kollin Cannon, PT
• Samuel Carr
• Megan Nicole Case, SLP
• Brenda Lee Chapman
• Nicole Clark, HAIR LOSS SPECIALIST
• Rosie Love Clark
• Jennifer Ruth Clarke, FNP
• Coast Family Physicians, P.a.
• Coastal Christian Counseling
• Coastal Family Health Center

• Optometrist in Long Beach, MS
• Providers in Long Beach, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.