NPIMap

Organization Active NPI

DRS. McClow, Clark & Berk PA

  • Diagnostic Radiology Physician
  • Orange Park, FL
National Provider Identifier
1417602467
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
DRS. MCCLOW, CLARK & BERK PA
Practice address
2300 Park Ave
Orange Park, FL 32073-5571
Phone
(904) 215-2580
NPI assigned
Feb 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Authorized official

Name
Dr. Ario Rezaei, MD
Title
President
Phone
(904) 388-6949

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

2300 Park Ave
Orange Park, FL 32073-5571

Mailing address

PO Box 161180
Altamonte Springs, FL 32716-1180
Phone (904) 388-6949

Other names 1

  • MCB Radiology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
DRS McClow Clark Berk PA14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

2300 Park Ave
Orange Park, FL 32073
Phone (352) 208-4154

NPI Registry JSON

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1417602467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 161180",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327161180",
            "telephone_number": "904-388-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 PARK AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735571",
            "telephone_number": "904-215-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. MCCLOW, CLARK & BERK PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-18",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "REZAEI",
        "authorized_official_first_name": "ARIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-388-6949",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCB Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.