Douglas A Clark, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

14762 Issued in AZ

Practice address

2055 E Southern Ave
Suite G
Tempe, AZ 85282-7507

Phone

(480) 839-0008

Fax

(480) 838-3333

NPI assigned

Jan 4, 2007

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 AZ

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

Specialty

Orthopedic Surgery

Education

Loma Linda University School of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Douglas a Clark MD PC

  • Orthopaedic Surgery Physician
  • Tempe, AZ
  • NPI 1780952259
  Medicare reassignment NPD Authorized official
• The Desert Sports Medicine and Shoulder Clinic LLC

  • Orthopaedic Surgery Physician
  • Mesa, AZ
  • NPI 1235301466
  NPD

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396892907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 E SOUTHERN AVE",
            "address_2": "SUITE G",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827507",
            "telephone_number": "480-839-0008",
            "fax_number": "480-838-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 E SOUTHERN AVE",
            "address_2": "SUITE G",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827507",
            "telephone_number": "480-839-0008",
            "fax_number": "480-838-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DOUGLAS",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "14762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarity Psychiatry
• Clarity Therapy LLC
• Tina Marie Clark-Dent, LPC
• Daniel E Clark, ND
• Doreen Chara Clark, LMFT,LPC
• Kayla Ashley Clark
• Lisa T Clark, LPC
• Mariana Marisela Clark, LPC
• Melissa Clark, ND
• Mlee R Clark, LMT, CLT

• Orthopaedic Surgery Physician in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Orthopaedic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• 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.