Roderick V. Clark, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

019518 Issued in LA

Practice address

2804 Ambassador Caffery Pkwy
Lafayette, LA 70506-5906

Phone

(337) 981-5156

Fax

(337) 981-0673

NPI assigned

Jun 29, 2006

Last updated

Sep 11, 2007By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

NephrologyAlso: Internal Medicine

Education

Louisiana State University School of Medicine in New Orleans, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acadiana Renal Physicians AMCGroup PAC ID 5890783070, 16 clinicians

Gulf Coast Nephrology, LLCGroup PAC ID 1052787959, 3 clinicians

Louisiana Kidney Update LLCGroup PAC ID 9032479548, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fmcna - Breaux Bridge Dialysis facility, Breaux Bridge, LA, CCN 192643
• Our Lady of Lourdes Regional Medical Center, Inc Hospital, Lafayette, LA, CCN 190102
• Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002
• Ochsner St Martin Hospital Hospital, Breaux Bridge, LA, CCN 191302
• Opelousas General Health System Hospital, Opelousas, LA, CCN 190017
• Iberia Medical Center Hospital, New Iberia, LA, CCN 190054

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rclark21204@direct.acumenmd.com

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.

• Acadiana Renal Physicians AMC

  • Nephrology Physician
  • Lafayette, LA
  • NPI 1992747349
  Medicare reassignment Care Compare group NPD
• Gulf Coast Nephrology, LLC

  • Nephrology Physician
  • Lake Charles, LA
  • NPI 1982340774
  Medicare reassignment Care Compare group NPD
• Louisiana Kidney Update, LLC

  • Nephrology Physician
  • Lafayette, LA
  • NPI 1104014349
  Medicare reassignment Care Compare group
• Lsuhn Billing LLC

  • Multi-Specialty Clinic/Center
  • Lafayette, LA
  • NPI 1992975775
  Medicare reassignment NPD
• Our Lady of Lourdes Regional Medical Center Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1952497489
  Medicare reassignment NPD
• Lsuhn Billing LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Baton Rouge, LA
  • NPI 1306247556
  NPD
• Our Lady of Lourdes Regional Medical Center

  • Emergency Medicine Physician
  • Lafayette, LA
  • NPI 1538181128
  NPD
• Fresenius Medical Care Broussard, LLC

  dba Fresenius Kidney Care Broussard

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lafayette, LA
  • NPI 1568079085
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bio-Medical Applications of Louisiana, LLC

  dba FMC Dialysis Services Breaux Bridge

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Breaux Bridge, LA
  • NPI 1700998580

  Dialysis facility

  Care Compare affiliation Name & address match
• Hospital Service District No 1 of Iberia Parish

  dba Iberia Medical Center

  • Rehabilitation Hospital Unit
  • New Iberia, LA
  • NPI 1992159925
  Care Compare affiliation
• Hospital Service District No. 1 of Iberia Parish

  dba Iberia Medical Center

  • General Acute Care Hospital
  • New Iberia, LA
  • NPI 1285601088
  Care Compare affiliation
• Lafayette General Medical Center Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1275536799
  Care Compare affiliation
• Opelousas General Hospital Authority

  • General Acute Care Hospital
  • Opelousas, LA
  • NPI 1447230388
  Care Compare affiliation
• Our Lady of Lourdes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1598766495
  Care Compare affiliation
• St Martin Hospital, Inc.

  dba St Martin Hospital

  • Critical Access Hospital
  • Breaux Bridge, LA
  • NPI 1437482817
  Care Compare affiliation

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1225066939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705065906",
            "telephone_number": "337-981-5156",
            "fax_number": "337-981-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705065906",
            "telephone_number": "337-981-5156",
            "fax_number": "337-981-0673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "RODERICK",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "019518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1379875",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Clark Mills, PHYSICAL THERAPIST
• Aja Clark
• Cassie Clark
• Jacob Scott Clark, D.C.
• Robert D Clark, CRNA
• Ross Clark
• Andrew F. Clarke, M.D.
• Fran F Clarke, LCSW BCD
• Lizabeth F Clarke, MD
• Clarte Counseling, LLC

• Nephrology Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Nephrology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.