Active NPI
Andrew Phillip Clark, L.AC. LMT
- Acupuncturist
- Dover, NH
National Provider Identifier
1386013852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 279
- Practice address
- 251 Central Ave
Dover, NH 03820-4188 - Phone
- (917) 771-7163
- NPI assigned
- Sep 15, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 005636-1 | NY | |
| Acupuncturist | 171100000X | 279 | NH | Primary |
Addresses
Primary practice location
251 Central Ave
Dover, NH 03820-4188
Mailing address
17 Snows CT
Dover, NH 03820-3307
Phone (917) 771-7163
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 279 | NH | MD | Registered Dietitian |
| 005636-1 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553212800000",
"number": "1386013852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 SNOWS CT",
"city": "DOVER",
"state": "NH",
"postal_code": "038203307",
"telephone_number": "917-771-7163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "251 CENTRAL AVE",
"city": "DOVER",
"state": "NH",
"postal_code": "038204188",
"telephone_number": "917-771-7163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "ANDREW",
"middle_name": "PHILLIP",
"name_prefix": "Mr.",
"credential": "L.AC. LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-15",
"last_updated": "2019-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "005636-1",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NH",
"license": "279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dover, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.