Thomas R Clark, DC, CCSP, PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6532 Issued in TX

Practice address

2418 W 9TH Ave
Amarillo, TX 79106-6620

Phone

(806) 372-3361

NPI assigned

Apr 10, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Thomas R. Clark, D.C., P.a.

  • Chiropractor
  • Amarillo, TX
  • NPI 1376801639
  NPD (past) Authorized official

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1487877213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 W 9TH AVE",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791066620",
            "telephone_number": "806-372-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 W 9TH AVE",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791066620",
            "telephone_number": "806-372-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "THOMAS",
        "middle_name": "R",
        "credential": "DC, CCSP, PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "6532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C06053679",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Clark, MA, LPC
• Jarrod Clark, PHARMD
• Kathleen Anne Clark, M.D.
• Summer Clark, M.D.
• Terry Clark, PHARM.D.
• Wanda Lu Clark, FNP
• Lee Anne Clarke, RPH
• Class I Dental Associates, P.L.L.C
• Beverly J Clawson
• Chelsie Renee Clawson, LPC

• Chiropractor in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.