John D Clark, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

ME169258 Issued in FL

Practice address

1340 S 18TH St Ste 104
Fernandina Beach, FL 32034-4733

Phone

(904) 277-3311

Fax

(904) 277-3343

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Neurology

Education

University of Oklahoma College of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Neurology IncGroup PAC ID 0345366704, 47 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Medical Center - Nassau Hospital, Fernandina Beach, FL, CCN 100140
• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117

Merit-based Incentive Payment System (MIPS)

Final score

88.46 of 100Reported as group

Quality

75.65

Promoting interoperability

100

Improvement activities

40

Cost

80.06

Merit-based Incentive Payment System (MIPS)

Final score

87.1 of 100Reported as group

Quality

79.76

Promoting interoperability

99

Improvement activities

40

Cost

78.08

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jclark186545@baptisthealthsystemjacksonville.direct-ci.com
• Direct secure messaging: john.clark@direct.lmh.org

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.

• Baptist Neurology Inc

  • Neurology Physician
  • Jacksonville, FL
  • NPI 1598995599
  Medicare reassignment Care Compare group NPD
• Lawrence Physicians LLC

  • Hospitalist Physician
  • Lawrence, KS
  • NPI 1841607090
  NPD
• Northland Neurological Associates, P.C.

  • Neurology Physician
  • North Kansas City, MO
  • NPI 1972540524
  NPD (past)

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

• Baptist Medical Center of Nassau Inc

  • General Acute Care Hospital
  • Fernandina Beach, FL
  • NPI 1518024462
  Care Compare affiliation
• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1235166943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746649",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746649",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 S 18TH ST STE 104",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344733",
            "telephone_number": "904-277-3311",
            "fax_number": "904-277-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KS",
            "license": "04-23864",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME169258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200300630A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christian Caregivers Healthcare
• Michelle Christie
• Sharon Ann Chunn, LMHC, LPC
• City of Fernandina Beach
• Clarity Professional Hearing Aid Center
• Kathryn A Clark, PHARM D
• Coastal Community Health Services, Inc.
• William Harmon Andrew Collins, R.PH., D.PH., P.D.
• Compassion4U Care Management, PLLC
• Complete Psychiatric Care

• Neurology Physician in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.