Raymond George Clark, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

421 Issued in ND

Practice address

1306 23Rd St S
Fargo, ND 58103-3707

Phone

(701) 235-1360

Fax

(701) 235-1360

NPI assigned

Sep 20, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Chiropractic

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619075298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 23RD ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033707",
            "telephone_number": "701-235-1360",
            "fax_number": "701-235-1360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 23RD ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033707",
            "telephone_number": "701-235-1360",
            "fax_number": "701-235-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "RAYMOND",
        "middle_name": "GEORGE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Clark, PHARM.D.
• David Joseph Clark, PHARMD
• Gregory D Clark, MSW
• Jay Clark
• Justine Clark
• Riley Clark, M.D.
• Timothy Clark
• Alveria P Clarke
• Grace J Clarke
• Justin Clarke

• Chiropractor in Fargo, ND
• Providers in Fargo, ND by specialty
• Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.