Michael T Clark, D. C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

11809510184A Issued in NH

Practice address

23 Charles St
Rochester, NH 03867-2926

Phone

(603) 332-8989

Fax

(603) 332-8989

NPI assigned

Apr 11, 2006

Last updated

Jan 29, 2016By the provider in NPPES

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

Other identifiers 9

Other names 1

• Dr. Michael T Clark Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1275596041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 CHARLES ST",
            "city": "ROCHESTER",
            "state": "NH",
            "postal_code": "038672926",
            "telephone_number": "603-332-8989",
            "fax_number": "603-332-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CHARLES ST",
            "city": "ROCHESTER",
            "state": "NH",
            "postal_code": "038672926",
            "telephone_number": "603-332-8989",
            "fax_number": "603-332-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D. C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NH",
            "license": "11809510184A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "AA44982",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3228",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "0508438Y0NH01",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "453731",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST NA",
            "identifier": "63665",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MATTHEW THORNTON HEALTH P",
            "identifier": "19394",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST HC",
            "identifier": "80705",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30001768",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM NJ",
            "identifier": "7802 OUT OF STATE",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "CLARK",
            "middle_name": "T",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Laurie Chase, MS
• Terasa Chaurasia
• Jennifer Chesley, RN
• Herbert C. Clark, O.D.
• Kenneth P Clark, O.D.
• Kendra Cline, APRN
• Kendra E Cline, APRN
• Patricia Ann Clough, MS, LMFT
• Wendy Susan Clough, RPH
• Coastal Comfort Home Healthcare, LLC

• Chiropractor in Rochester, NH
• Providers in Rochester, NH by specialty
• Chiropractor in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; 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.