Jan Dean Clark, DMD

Primary specialty

PodiatristTaxonomy code 213E00000X

License

79 Issued in MT

Practice address

300 No Willson
602F
Bozeman, MT 59715

Phone

(406) 586-5318

Fax

(406) 586-1635

NPI assigned

Jan 8, 2007

Last updated

Oct 1, 2024By 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 MT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

California School of Podiatric Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bozeman Podiatric Clinic IncGroup PAC ID 6507947652, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Bozeman Podiatric Clinic Inc

  • Foot & Ankle Surgery Podiatrist
  • Bozeman, MT
  • NPI 1144404401
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1497803803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 W KAGY BLVD STE 101",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597155879",
            "telephone_number": "406-586-5318",
            "fax_number": "406-586-1635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NO WILLSON",
            "address_2": "602F",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59715",
            "telephone_number": "406-586-5318",
            "fax_number": "406-586-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JAN",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MT",
            "license": "79",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0390091",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claire Forsman Counseling
• Clark Fork Healthcare, LLC (Big Sky Hospice)
• Clark Fork Healthcare, LLC (Big Sky Home Health)
• Christina Rae Clark, L.AC. MSOM, DIPL.OM
• Erin Nicole Clark, MSW
• Rosemary Clause, LMHC
• Sonja Ruth Clausen, PHARMD
• Edward Allen Claussen, PHARMD
• Clearwater Health and Rehab LLC (Clearwater Physical Therapy)
• Clearwater Healthcare

• Podiatrist in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Podiatrist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.