Christopher Patrick Clark, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

RTP003586 Issued in GA

Practice address

4700 Las Vegas Blvd N
Mike O Callaghan Federal Medical Center
Nellis AFB, NV 89191-6600

Phone

(702) 653-2344

NPI assigned

Dec 28, 2007

Last updated

Apr 3, 2014By the provider in NPPES

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 CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Professionals of Colorado, PC

  • Emergency Medicine Physician
  • Loveland, CO
  • NPI 1396496469
  Medicare reassignment NPD
• Emergency Professionals of Colorado, PC

  • Emergency Medicine Physician
  • Greeley, CO
  • NPI 1366835415
  NPD
• East Morgan County Hospital

  • Critical Access Hospital
  • Brush, CO
  • NPI 1699708743
  NPD (past)
• Emergency Professionals of Colorado, PC

  • Emergency Medicine Physician
  • Greeley, CO
  • NPI 1306421201
  NPD (past)
• Emergency Professionals of Colorado, PC

  • Emergency Medicine Physician
  • Sterling, CO
  • NPI 1558946467
  NPD (past)
• Emergency Professionals of Colorado, PC

  • Emergency Medicine Physician
  • Fort Collins, CO
  • NPI 1588249494
  NPD (past)

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396483200000",
    "number": "1639353493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3912 SAN ESTEBAN AVE",
            "address_2": "APT/SUITE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890842327",
            "telephone_number": "361-215-7363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "address_2": "MIKE O CALLAGHAN FEDERAL MEDICAL CENTER",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHRISTOPHER",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-28",
        "last_updated": "2014-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "RTP003586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Lester C Chua, CRNA
• Tyson Chung, DDS
• Brooke Lokie Clampitt, M.D.
• Michael Clampitt, M.D.
• Christopher Lee Clark, IDMT
• William N Clark, CRNA
• Benjamin R Clarke, D.D.S.
• Alaina Claudio
• Dillon M Cleary, M.D.
• Amanda Lee Co, NURSE PRACTITIONER

• Emergency Medicine Physician in Nellis AFB, NV
• Providers in Nellis AFB, NV by specialty
• Emergency Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.