NPIMap

Individual provider Active NPI

John Mirrell Clark, MD

  • Internal Medicine Physician
  • Hurricane, WV
National Provider Identifier
1609815786
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
21953 Issued in WV
Practice address
3860 Teays Valley Rd
Suite 4
Hurricane, WV 25526-9772
Phone
(304) 201-2545
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 21953 WV Primary

Addresses

Primary practice location

3860 Teays Valley Rd
Suite 4
Hurricane, WV 25526-9772

Mailing address

4023 Farmington Dr
Hurricane, WV 25526-8756
Phone (304) 881-4225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060810000002 WV Practitioner - Internal MedicinePractitioner - Addiction Medicine 5698778785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Addiction Medicine
Education
West Virginia University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
THS Physician Partners IncGroup PAC ID 9537316393, 366 clinicians

Practice addresses (Care Compare)

11924 Winfield Rd
Winfield, WV 25213-7913
Phone (304) 306-3060

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, South Charleston, WV, CCN 517048
  • Thomas Memorial Hospital Hospital, South Charleston, WV, CCN 510029
  • Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
THS Physician Partners Inc Internal Medicine CurrentSince Apr 30, 2024 Accepting new patients
John M Clark MD Past Accepting new patients

Locations

L3539
Columbus, OH 43260
Phone (304) 414-4800

3006 Mount Vernon Rd
Ste 1070
Hurricane, WV 25526
Phone (304) 201-2545

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

11924 Winfield Rd
Winfield, WV 25213
Phone (304) 306-3060

Organizations & group practices 2

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609815786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4023 FARMINGTON DR",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255268756",
            "telephone_number": "304-881-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 TEAYS VALLEY RD",
            "address_2": "SUITE 4",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269772",
            "telephone_number": "304-201-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JOHN",
        "middle_name": "MIRRELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "21953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurricane, WV

Sources for this page

Verify at the official NPI Registry.