NPIMap

Individual provider Active NPI

Shawn B Clark, M.D.

  • Neurological Surgery Physician
  • Mobile, AL
National Provider Identifier
1306849575
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
23993 Issued in AL
Practice address
6701 Airport Blvd Ste D146
Mobile, AL 36608-3784
Phone
(251) 287-2176
Fax
(251) 287-2279
NPI assigned
May 23, 2005
Last updated
Feb 17, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 23993 AL Primary

Addresses

Primary practice location

6701 Airport Blvd Ste D146
Mobile, AL 36608-3784

Mailing address

6701 Airport Blvd Ste D146
Mobile, AL 36608-3784
Phone (251) 287-2176

Other identifiers 1

IdentifierTypeStateIssuer
120636MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100810000124 AL Practitioner - Neurosurgery 4486668902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shawn Clark, MD, PCGroup PAC ID 0143459776, 5 clinicians

Practice addresses (Care Compare)

6701 Airport Blvd
Suite D146
Mobile, AL 36608-6701
Phone (251) 287-2176

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.3 of 100Reported as group
Quality
65.18
Promoting interoperability
96
Improvement activities
40
Cost
72.48

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion405
Laminectomy or laminotomy (partial removal of spine bones)93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23993ALMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shawn Clark, M.D., P.C. CurrentSince Jan 15, 2014 Accepting new patients

Locations

6701 Airport Blvd
Mobile, AL 36608
Phone (251) 545-4776

6701 Airport Blvd
Ste C138
Mobile, AL 36608
Phone (251) 333-3333

6701 Airport Blvd
Ste D146
Mobile, AL 36608
Phone (251) 287-2176

Organizations & group practices 1

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1306849575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 AIRPORT BLVD STE D146",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366083784",
            "telephone_number": "251-287-2176",
            "fax_number": "251-287-2279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 AIRPORT BLVD STE D146",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366083784",
            "telephone_number": "251-287-2176",
            "fax_number": "251-287-2279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SHAWN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AL",
            "license": "23993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120636",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.