NPIMap

Organization Active NPI

Joshua J Clark MD LLC

  • Dermatology Physician
  • Springfield, OR
National Provider Identifier
1346994811
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
JOSHUA J CLARK MD LLC
Practice address
1605 G St
Springfield, OR 97477-4227
Phone
(541) 747-6159
Fax
(541) 741-7249
NPI assigned
Feb 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Authorized official

Name
Joshua John Clark, MDNPI 1710349592
Title
Physician
Phone
(801) 657-9130

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

1605 G St
Springfield, OR 97477-4227

Mailing address

1605 G St
Springfield, OR 97477-4227
Phone (541) 747-6159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220517002988 OR Part B Supplier - Clinic/Group Practice 7618354432 Receives reassigned benefits from 4 practitioners
Practice locations: Springfield, OR

National Provider Directory

National Provider Directory

Locations

1605 G St
Springfield, OR 97477
Phone (541) 741-2100

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1346994811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 G ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774227",
            "telephone_number": "541-747-6159",
            "fax_number": "541-741-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 G ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774227",
            "telephone_number": "541-747-6159",
            "fax_number": "541-741-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSHUA J CLARK MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-04",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "801-657-9130",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.