Organization Active NPI

Clarke Eye Clinic, Inc.

  • Optometrist
  • Beckley, WV
National Provider Identifier
1356534267
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
827OD Issued in WV
Legal business name
CLARKE EYE CLINIC, INC.
Practice address
215 N Kanawha St
Beckley, WV 25801-4716
Phone
(304) 253-2020
Fax
(304) 253-2340
NPI assigned
Aug 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

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

Authorized official

Name
Dr. David G Clarke, O.D.NPI 1255391595
Title
Persident
Phone
(304) 253-2020

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 827OD WV Primary

Addresses

Primary practice location

215 N Kanawha St
Beckley, WV 25801-4716

Mailing address

215 N Kanawha St
Beckley, WV 25801-4716
Phone (304) 253-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930073672 WV DME Supplier - Physician - Optometrist 3476671900 Practice locations: Beckley, WV
O20120119000109 WV Part B Supplier - Clinic/Group Practice 3476671900 Receives reassigned benefits from 1 practitioner
Practice locations: Beckley, WV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Clarke Eye Clinic Inc215 N Kanawha St, Beckley, WV 25801-4716(304) 253-2020 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

215 N Kanawha St
Beckley, WV 25801
Phone (304) 253-2020

Practitioners & affiliated clinicians

Practitioners 1

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": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232496000000",
    "number": "1356534267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N KANAWHA ST",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014716",
            "telephone_number": "304-253-2020",
            "fax_number": "304-253-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N KANAWHA ST",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014716",
            "telephone_number": "304-253-2020",
            "fax_number": "304-253-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKE EYE CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2009-01-21",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PERSIDENT",
        "authorized_official_telephone_number": "304-253-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WV",
            "license": "827OD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; 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.