Rodney Keith Clark, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12507 Issued in GA

Practice address

1918 Forsyth Street
Macon, GA 31201

Phone

(478) 746-0046

NPI assigned

Apr 26, 2007

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

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Clark General Dentistry Center, P.C.

  • Dentist
  • Macon, GA
  • NPI 1740543776
  NPD (past) Authorized official

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220572800000",
    "number": "1285854919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 FORSYTH STREET",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "telephone_number": "478-746-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 FORSYTH STREET",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "telephone_number": "478-746-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "RODNEY",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2008-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "12507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie J Clark, FNP-BC
• Kameron Alexander Clark, MD
• Kiofa Enez Clark, D.C.
• Lauren Clark
• Lowell Clark, MD
• Claudes Loving Hands LLC
• Claxton-Graves, Inc
• Cherrice Clay-Austin, NP
• Arielle Marie Clay, MD
• Dwayne Lee Clay, M.D.

• General Practice Dentistry in Macon, GA
• Providers in Macon, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.