David W Clark, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

04-27540 Issued in KS

Practice address

12300 Metcalf Ave
Overland Park, KS 66213-1324

Phone

(913) 317-7485

NPI assigned

Aug 3, 2005

Last updated

Jul 14, 2008By the provider in NPPES

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 8

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northwest HBP Medical Services LLC

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1407353006
  Medicare reassignment NPD
• Progressive Medical Associates PLLC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1548218613
  Medicare reassignment NPD
• Sound Physicians Emergency Medicine of Arizona, Inc.

  • Emergency Medicine Physician
  • Sierra Vista, AZ
  • NPI 1700328663
  Medicare reassignment NPD
• ER Physicians South PA

  • Emergency Medicine Physician
  • Ottawa, KS
  • NPI 1194100057
  NPD (past)
• Saint Luke's South Hospital Inc.

  • Renal Nutrition Registered Dietitian
  • Overland Park, KS
  • NPI 1669606737
  NPD (past)
• Shawnee Mission Medical Center

  dba SMMC Emergency Physicians

  • Emergency Medical Services (Emergency Medicine) Physician
  • Shawnee Mission, KS
  • NPI 1598970790
  NPD (past)

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1265433940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411039",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641411039",
            "telephone_number": "913-234-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131324",
            "telephone_number": "913-317-7485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DAVID",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KS",
            "license": "04-27540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KC MO",
            "identifier": "25062057",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208678029",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP DC6712",
            "identifier": "P00188856",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100317940A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KC MO GROUP  ID #",
            "identifier": "01674018",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP CG8899",
            "identifier": "930066218",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KC MO",
            "identifier": "25062077",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100317940C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Jeffrey Clark, DC
• Anne S. Clark, M.D.
• Carolyn Mae Clark, M.D.
• Cindy Clark, COTA
• David Frederick Clark, MD
• Dionna Rae Clark, TEMPORARY- LICENSED
• Ellen C Clark, RBT
• Garrett Clark
• Heather J Clark, PHARMD
• Jayden Clark

• Emergency Medicine Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Emergency Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.