Terry L Clark, MD

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

R-3194 Issued in AR

Practice address

4300 Regions Park Dr
Fort Smith, AR 72916-9373

Phone

(479) 274-6300

Fax

(479) 484-4715

NPI assigned

Jul 3, 2006

Last updated

Aug 28, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

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 Medicine

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.

• Mercy Clinic Fort Smith Communities

  • Multi-Specialty Clinic/Center
  • Fort Smith, AR
  • NPI 1902073620
  Medicare reassignment NPD
• Mercy Clinic Fort Smith Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Smith, AR
  • NPI 1790258002
  NPD
• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  NPD (past)
• Paul Rust Inc.

  • Clinical Social Worker
  • Fort Smith, AR
  • NPI 1184657108
  NPD (past)
• St. Edward Medical Services, Inc

  • Emergency Care Clinic/Center
  • Fort Smith, AR
  • NPI 1760440143
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1184654774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3528",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729133528",
            "telephone_number": "479-274-2000",
            "fax_number": "479-274-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 REGIONS PARK DR",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729169373",
            "telephone_number": "479-274-6300",
            "fax_number": "479-484-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TERRY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "AR",
            "license": "R-3194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080101199",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111575001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Ann Clark
• Jenna Clark, MS, RD, LD, CPT
• Joshua A Clark, M.D.
• Rebecca Clark, COTA
• Scott Matthew Clark, DC
• Courtney Clawson
• Clear View Radiology, PLLC
• Allison D Clem, RPH
• Ward William Clemmons, D.D.S., P.A.
• Jerry C Clemons, DDS

• Occupational Medicine Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Occupational Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; 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.