Active NPI
Matthew Emil Clark
- Health Educator
- Goffstown, NH
National Provider Identifier
1225611304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- Practice address
- 116 Goffstown Back Rd
Goffstown, NH 03045-2641 - Phone
- (603) 497-4663
- NPI assigned
- May 5, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | Primary |
Addresses
Primary practice location
116 Goffstown Back Rd
Goffstown, NH 03045-2641
Mailing address
22 Carriage Rd
New Boston, NH 03070-5128
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620172800000",
"number": "1225611304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 CARRIAGE RD",
"city": "NEW BOSTON",
"state": "NH",
"postal_code": "030705128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 GOFFSTOWN BACK RD",
"city": "GOFFSTOWN",
"state": "NH",
"postal_code": "030452641",
"telephone_number": "603-497-4663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "MATTHEW",
"middle_name": "EMIL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-05",
"last_updated": "2021-05-05",
"certification_date": "2021-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goffstown, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.