Cynthia L Clark, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1151 Issued in SD

Practice address

825 E 8TH St Ste 100
Winner, SD 57580-2634

Phone

(605) 842-2626

Fax

(605) 842-3557

NPI assigned

Apr 26, 2006

Last updated

Mar 19, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SD

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)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Winner Regional Healthcare Center

  • Critical Access Hospital
  • Winner, SD
  • NPI 1538233549
  Medicare reassignment
• Independent Family Doctors

  • Family Medicine Physician
  • Fargo, ND
  • NPI 1659477149
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363651200000",
    "number": "1346206430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585",
            "fax_number": "605-328-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 E 8TH ST STE 100",
            "city": "WINNER",
            "state": "SD",
            "postal_code": "575802634",
            "telephone_number": "605-842-2626",
            "fax_number": "605-842-3557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CYNTHIA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2013-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "5797",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "1151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "711298000",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14513",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judy J. Bartels, R.N.
• Robyn Brazelton
• Donna Raye Brown, MS
• Renee Burnham, DPT
• Matthew Douglas Bury, D.D.S.
• Kenneth A Clefisch
• Naomi J Colberg, MS NCC
• Community Connections Inc
• Charles Michael Corkle, D.D.S.
• County of Tripp

• Family Medicine Physician in Winner, SD
• Providers in Winner, SD by specialty
• Family Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; 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.