Robert W Clark, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

917 Issued in OH

Practice address

12 W Wenger Rd
Englewood, OH 45322-2754

Phone

(937) 836-1288

Fax

(937) 832-1251

NPI assigned

Feb 27, 2008

Last updated

Nov 19, 2012By 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

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Los Angeles, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Clark Chiropractic Inc

  • Chiropractor
  • Englewood, OH
  • NPI 1982744264
  Authorized official Same address or phone

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1336318047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 W WENGER RD",
            "address_2": "SUITE 6",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453222754",
            "telephone_number": "937-836-1288",
            "fax_number": "937-832-1251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 W WENGER RD",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453222754",
            "telephone_number": "937-836-1288",
            "fax_number": "937-832-1251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ROBERT",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-27",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda Church, RN
• City of Clayton (Clayton Fire Department)
• City of Englewood
• Clark Chiropractic Inc
• Dominque Clark
• Steven M Clark
• Sarah Clawson
• Stacey L Coleman
• Susan Elizabeth Collar
• Rahhshahun Colley

• Chiropractor in Englewood, OH
• Providers in Englewood, OH by specialty
• Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.