NPIMap

Organization Active NPI

Craig D. Clark, M.D., Professional Corp.

  • Orthopaedic Surgery Physician
  • Henderson, NV
National Provider Identifier
1407169048
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
CRAIG D. CLARK, M.D., PROFESSIONAL CORP.
Practice address
2405 W Horizon Ridge Pkwy
Suite 100
Henderson, NV 89052-2717
Phone
(702) 982-1300
Fax
(702) 898-8767
NPI assigned
Jul 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Authorized official

Name
Dr. Craig D Clark, MD
Title
President
Phone
(702) 528-7057

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

2405 W Horizon Ridge Pkwy
Suite 100
Henderson, NV 89052-2717

Mailing address

PO Box 530278
Henderson, NV 89053-0278
Phone (702) 982-1300

National Provider Directory

National Provider Directory

Locations

2405 W Horizon Ridge Pkwy
Henderson, NV 89052
Phone (702) 982-1300

Practitioners & affiliated clinicians

Practitioners 6

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": "1280016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319587200000",
    "number": "1407169048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530278",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890530278",
            "telephone_number": "702-982-1300",
            "fax_number": "702-898-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 W HORIZON RIDGE PKWY",
            "address_2": "SUITE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522717",
            "telephone_number": "702-982-1300",
            "fax_number": "702-898-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIG D. CLARK, M.D., PROFESSIONAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-25",
        "last_updated": "2011-10-26",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-528-7057",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.