Clark Bishop II, 4704202764

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704202764 Issued in MI

Practice address

1700 Waterman St
Detroit, MI 48209-2022

Phone

(313) 841-8900

NPI assigned

Dec 26, 2013

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1388016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388016000000",
    "number": "1194146845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26766 STANFORD ST",
            "city": "INKSTER",
            "state": "MI",
            "postal_code": "481413135",
            "telephone_number": "313-283-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WATERMAN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482092022",
            "telephone_number": "313-841-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "CLARK",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "4704202764",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-26",
        "last_updated": "2013-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704202764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ilene Bishaw
• Ivan Arthur Bishaw Jr., M.S. LBSW
• Brooke Irene Bishop
• Carter R Bishop, MD
• Chad A Bishop
• Denette Michelle Bishop
• Jada Bishop
• Melvin L Bishop
• Rachel Anne Learman Bishop
• Tracy Hillary Bishop, MSW

• Registered Nurse in Detroit, MI
• Providers in Detroit, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.