Thomas W Clark, M.S., M.D., F.A.C.S.

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101050712 Issued in VA

Practice address

645 J Clyde Morris Blvd
Newport News, VA 23601-1819

Phone

(757) 591-9572

Fax

(757) 591-9606

NPI assigned

Dec 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

State licenses

Practice roles

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.

• Center for Weight Loss Success, P.C.

  • Surgery Physician
  • Newport News, VA
  • NPI 1497053557
  NPD (past) Authorized official
• Weight Loss Surgery Center

  • Specialist
  • Newport News, VA
  • NPI 1245394394
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255494183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 J CLYDE MORRIS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011819",
            "telephone_number": "757-591-9572",
            "fax_number": "757-591-9606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 J CLYDE MORRIS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011819",
            "telephone_number": "757-591-9572",
            "fax_number": "757-591-9606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "THOMAS",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.S., M.D., F.A.C.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101050712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "453810",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7312059",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna Patricia Clark, NURSE PRACTITIONER
• Matthew Mitchell Clark, DMD
• NA'Zae Athena Clark, PA-C
• Sarah Clark, MOT
• Theresa Hitselberger Clark, MD
• Tyler S Clark, DPT
• Crystal Clary, LPC
• Susan Elaine Claud, CRNA
• Jacquelyn Dawn Claude, RN
• Matthew T. Claus

• Specialist in Newport News, VA
• Providers in Newport News, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.