Timothy Clark, RPA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.007543RX Issued in OH

Practice address

1200 Vester Ave
Springfield, OH 45503-1304

Phone

(937) 828-2051

Fax

(937) 828-2052

NPI assigned

May 6, 2006

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

Medicare fee-for-service enrollment

Enrolled in NY, OH2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urgent Care Specialists, LLCGroup PAC ID 1850311010, 81 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Urgent Care Specialists, LLC

  • Urgent Care Clinic/Center
  • Huber Heights, OH
  • NPI 1114957123
  Medicare reassignment Care Compare group NPD
• CG Medical Associates Inc

  • Urgent Care Clinic/Center
  • Cincinnati, OH
  • NPI 1982903951
  Medicare reassignment
• Premier Health Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • Dayton, OH
  • NPI 1134633761
  Medicare reassignment
• Churchville-Chili Family Medicine, LLC

  • Family Medicine Physician
  • North Chili, NY
  • NPI 1326231291
  Medicare reassignment
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  OH

  Medicare reassignment
• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1063531929
  NPD (past)

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1629027974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 OAK CT STE 100",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454301064",
            "telephone_number": "937-404-1101",
            "fax_number": "937-404-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 VESTER AVE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455031304",
            "telephone_number": "937-828-2051",
            "fax_number": "937-828-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TIMOTHY",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007543RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Lynn Clark, RN
• Eric Clark
• Jennifer Clark
• Kandice Clark
• Latasha Nichole Clark
• Daniel George Clauer, D.D.S.
• Nicole Clem
• Katelyn Marie Clevenger
• Carrie Clevland
• Gene A. Clifton, D.D.S.

• Physician Assistant in Springfield, OH
• Providers in Springfield, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; 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.