John Gregory Clark, D.C.

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

17061 Issued in CA

Practice address

7461 N 1St St
Ste 103
Fresno, CA 93720-2850

Phone

(559) 226-3400

Fax

(559) 226-3963

NPI assigned

Oct 6, 2006

Last updated

Jan 25, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 CA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 1984

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

  • Orthopedic Chiropractor
  • Fresno, CA
  • NPI 1164706255
  Medicare reassignment NPD Authorized official
• Sullivan Chiropractic Center Inc

  • Chiropractor
  • Fresno, CA
  • NPI 1992000673
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516838400000",
    "number": "1386731677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4678 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937260903",
            "telephone_number": "559-226-3400",
            "fax_number": "559-226-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7461 N 1ST ST",
            "address_2": "STE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202850",
            "telephone_number": "559-226-3400",
            "fax_number": "559-226-3963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JOHN",
        "middle_name": "GREGORY",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2018-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "CA",
            "license": "17061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haylee Clark
• Jack Clark
• Jack Douglas Clark, M.D.
• Jaycee Clark
• Jhinnae Clark
• Kayla Nicole Clark
• Lauren Lya Clark, PHARMD
• Lorena Clark
• Natasha Monique Nicole Clark
• Paige Elizabeth Clark

• Orthopedic Chiropractor in Fresno, CA
• Providers in Fresno, CA by specialty
• Orthopedic Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; 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.