Lyle Arthur Clark, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

R8E55 Issued in MO

Practice address

141 Communication Drive
Hannibal, MO 63401

Phone

(573) 795-7342

Fax

(573) 248-3080

NPI assigned

Jul 18, 2006

Last updated

Jun 4, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602

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.

• Mark Twain Association for Mental Health, Inc.

  dba Mark Twain Behavioral Health

  • Community/Behavioral Health Agency
  • Hannibal, MO
  • NPI 1700933363
  Medicare reassignment NPD
• Mark Twain Association for Mental Health, Inc

  dba Mark Twain Behavioral Health

  • Community/Behavioral Health Agency
  • Hannibal, MO
  • NPI 1104368703
  NPD
• Comprehensive Health Systems, Inc

  • Community/Behavioral Health Agency
  • New London, MO
  • NPI 1306996012
  NPD (past)
• Hannibal Regional Healthcare System Inc

  • Multi-Specialty Clinic/Center
  • Hannibal, MO
  • NPI 1003956095
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1477572097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E LA HARPE ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014520",
            "telephone_number": "660-665-1962",
            "fax_number": "660-665-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 COMMUNICATION DRIVE",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "63401",
            "telephone_number": "573-795-7342",
            "fax_number": "573-248-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LYLE",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "R8E55",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208444604",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles W Janes DDS PC
• Chicago Hearing LLC (Miracle Ear)
• Robin K Christal, LPC
• Beverly Ann Christy, FNP-C
• Jill Marie Clark, MS, RD, LD
• Lyreva J Clark, RNFNP-C
• Edward A Cline, DPM
• Jane A Cline, PT
• Steven N. Cockrell, M.D.
• Savannah J Coelho, PLPC

• Psychiatry Physician in Hannibal, MO
• Providers in Hannibal, MO by specialty
• Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.