Active NPI
Mark S Clark
- Optician
- Clarksville, TN
National Provider Identifier
1548053291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 23108
- Practice address
- 2340 Bearden Rd
Clarksville, TN 37043-8719 - Phone
- (231) 884-2642
- NPI assigned
- May 27, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 23108 | MI | Primary |
Addresses
Primary practice location
2340 Bearden Rd
Clarksville, TN 37043-8719
Mailing address
2340 Bearden Rd
Clarksville, TN 37043-8719
Phone (231) 884-2642
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23108 | MI | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Keralink Eyewear Benefit Corp | Optician | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Optician
- Oakland, MD
- NPI 1629861380
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748304000000",
"number": "1548053291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2340 BEARDEN RD",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370438719",
"telephone_number": "231-884-2642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2340 BEARDEN RD",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370438719",
"telephone_number": "231-884-2642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "MARK",
"middle_name": "S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-05-27",
"last_updated": "2025-05-27",
"certification_date": "2025-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "MI",
"license": "23108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.