Dustin J Clark, D.C

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR.CH.60465702 Issued in WA

Practice address

601 S Race St
Port Angeles, WA 98362-6400

Phone

(360) 452-7636

NPI assigned

May 19, 2014

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

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Kansas City, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Clark Chiropractic and Massage PS

  • Clinic/Center
  • Port Angeles, WA
  • NPI 1659783363
  Medicare reassignment NPD Authorized official
• Gladstone Chiropractic Inc

  • Chiropractor
  • Kansas City, MO
  • NPI 1912649971
  NPD Authorized official
• Mittelstaedt Chiropractic Inc

  • Chiropractor
  • Port Angeles, WA
  • NPI 1376660050
  NPD

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1225449671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S RACE ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983626400",
            "telephone_number": "360-452-7636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S RACE ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983626400",
            "telephone_number": "360-452-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DUSTIN",
        "middle_name": "J",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-19",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CHIR.CH.60465702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clallam County Public Hospital District 2
• Fallon Ann Clancy, PA
• Michael A Clancy
• Clark Chiropractic and Massage PS
• Clark Counseling LLC
• Elizabeth A. Clark, LSW
• Hilary Jade Clark
• Katherine Clark
• Lisa Ann Clark
• Rachel Clark

• Chiropractor in Port Angeles, WA
• Providers in Port Angeles, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.