Ben P. Clark, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1035 Issued in SC

Practice address

116 Baskervill Dr
Palweys Island, SC 29585

Phone

(843) 357-2020

NPI assigned

Feb 2, 2006

Last updated

Apr 27, 2017By 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 names 1

• Ben P. Clark Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ben P Clark OD PA

  • Optometrist
  • Murrells Inlet, SC
  • NPI 1437312949
  NPD (past) Authorized official
• Ben P. Clark, OD PA

  • Optometrist
  • Murrells Inlet, SC
  • NPI 1982654109
  Authorized official Same address or phone

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1487626743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1307",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295851307",
            "telephone_number": "843-237-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 BASKERVILL DR",
            "city": "PALWEYS ISLAND",
            "state": "SC",
            "postal_code": "29585",
            "telephone_number": "843-357-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BEN",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEN",
            "last_name": "CLARK",
            "middle_name": "P.",
            "credential": "OD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.