NPIMap

Individual provider Active NPI

Nina Karni Clark

  • Family Medicine Physician
  • Newport, OR
National Provider Identifier
1508494337
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO224807 Issued in OR
Practice address
930 SW Abbey St Ste a
Newport, OR 97365-4820
Phone
(541) 265-8816
NPI assigned
Mar 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A21244 CA
Family Medicine Physician 207Q00000X DO224807 OR Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

930 SW Abbey St Ste a
Newport, OR 97365-4820

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other practice location 1

1740 W Taylor St
Chicago, IL 60612-7232
Phone (866) 600-2273

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nclark328926@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231013002075 CA Practitioner - Hospitalist 3072933001 Reassigns benefits to 2 organizations
I20250831000271 OR Practitioner - Family Practice 3072933001 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Pacific Health Services Inc 86 clinicians

Practice addresses (Care Compare)

930 SW Abbey St
Newport, OR 97365-4820

Hospital & facility affiliations

  • Samaritan Pacific Community Hospital Hospital, Newport, OR, CCN 381314
  • Good Samaritan Regional Medical Center Hospital, Corvallis, OR, CCN 380014
  • Samaritan Pacific Community Hospital Nursing home, CCN 38Z314

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A21244CAMDFamily Medicine Physician
DO224807ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quantum Bay Area Hospitalist Medical Group Inc CurrentSince Aug 29, 2023 Accepting new patients
Samaritan Pacific Health Services, Inc Current Accepting new patients
Samaritan Pacific Health Services, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Quantum Healthcare Medical Associates Inc. Family Medicine CurrentSince Aug 29, 2023 Accepting new patients
Samaritan Pacific Health Services, Inc CurrentSince Sep 1, 2025 Accepting new patients

Locations

2500 Grant Rd
Mountain View, CA 94040
Phone (650) 903-9500

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

225 N Jackson Ave
San Jose, CA 95116
Phone (408) 347-4051

2800 Benedict Dr
San Leandro, CA 94577
Phone (510) 357-8300

6001 Norris Canyon Rd
San Ramon, CA 94583
Phone (925) 275-8273

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

815 NW 9th St
Ste 215
Corvallis, OR 97330
Phone (541) 768-1888

930 SW Abbey St
Ste A
Newport, OR 97365
Phone (541) 265-2244

930 SW Abbey St
Newport, OR 97365
Phone (541) 265-2244

Interoperability endpoints

  • Direct secure messaging: nclark69278@uihealth.direct-ci.com

Organizations & group practices 10

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.

Hospital & facility affiliations 35

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1508494337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 SW ABBEY ST STE A",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973654820",
            "telephone_number": "541-265-8816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1740 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606127232",
            "country_code": "US",
            "telephone_number": "866-600-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "NINA",
        "middle_name": "KARNI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-28",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A21244",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO224807",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nclark328926@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "930 SW Abbey St Ste A",
            "city": "Newport",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973654820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newport, OR

Sources for this page

Verify at the official NPI Registry.