NPIMap

Individual provider Active NPI

Christian D Clark, MD

  • Gastroenterology Physician
  • Tulsa, OK
National Provider Identifier
1649223710
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
27511 Issued in OK
Practice address
6465 S Yale Ave
Suite 1002
Tulsa, OK 74136-7823
Phone
(918) 481-4700
Fax
(918) 481-4765
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 27511 OK Primary

Addresses

Primary practice location

6465 S Yale Ave
Suite 1002
Tulsa, OK 74136-7823

Mailing address

PO Box 305
Lowell, AR 72745-0305
Phone (918) 481-4706

Other identifiers 1

IdentifierTypeStateIssuer
200292330AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, OK, TX3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20060802000084 SC Practitioner - GastroenterologyPractitioner - Internal Medicine 4082627468 Reassigns benefits to 1 organization
I20100903000246 OK Practitioner - GastroenterologyPractitioner - Internal Medicine 4082627468 Reassigns benefits to 3 organizations
I20230220002773 TX Practitioner - Internal Medicine 4082627468 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cherokee NationGroup PAC ID 5799698742, 446 clinicians
Creek Nation Hospital and ClinicsGroup PAC ID 5698786226, 364 clinicians
Adult Gastroenterology Associates IncGroup PAC ID 0840223921, 15 clinicians

Practice addresses (Care Compare)

100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone (918) 458-3100

10109 E 79TH St
Tulsa, OK 74133-4564
Phone (918) 756-4333

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

4150 SE Adams Rd
Bartlesville, OK 74006-8410
Phone (918) 438-7050

Hospital & facility affiliations

  • Oklahoma Surgical Hospital, LLC Hospital, Tulsa, OK, CCN 370210
  • Saint Francis Hospital Vinita, Inc Hospital, Vinita, OK, CCN 370237
  • Bailey Medical Center, LLC Hospital, Owasso, OK, CCN 370228
  • Musc Medical Center Hospital, Charleston, SC, CCN 420004
  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091

Merit-based Incentive Payment System (MIPS)

Final score
84.37 of 100Reported as group
Quality
75.14
Promoting interoperability
98
Improvement activities
40
Cost
74.42

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as group
Quality
83.76
Promoting interoperability
100
Improvement activities
40
Cost
56.64

Merit-based Incentive Payment System (MIPS)

Final score
85.4 of 100Reported as group
Quality
72.78
Promoting interoperability
98
Improvement activities
40
Cost
76.77

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy239
Upper gastrointestinal (GI) endoscopy for acid reflux410

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Gastroenterology Current Accepting new patients
Stillwater Medical Center Authority Gastroenterology CurrentSince Aug 1, 2018 Accepting new patients
Stillwater Medical Center Authority CurrentSince Aug 1, 2018 Accepting new patients
Creek Nation Hospital & Clinics Gastroenterology CurrentSince Nov 9, 2022 Accepting new patients
Cherokee Nation CurrentSince Feb 17, 2024 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Sep 21, 2022 Accepting new patients
Cherokee Nation Current Accepting new patients
Creek Nation Hospital & Clinics Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Nov 9, 2022 Accepting new patients
Adult Gastroenterology Associates Inc Gastroenterology CurrentSince Aug 2, 2010 Accepting new patients
Cherokee Nation CurrentSince Feb 17, 2024 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Nov 9, 2022 Accepting new patients
Cherokee Nation Current Accepting new patients
University Medical Associates CurrentSince Sep 21, 2022 Accepting new patients
Cherokee Nation Past Accepting new patients
Oklahoma Surgical Hospital, LLC Past Accepting new patients

Locations

4150 SE Adams Rd
Bartlesville, OK 74006
Phone (918) 331-9979

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641

417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

1301 W 6th Ave
Ste 108
Stillwater, OK 74074
Phone (405) 533-1695

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 1467
Tulsa, OK 74182

6465 S Yale Ave
Ste 1002
Tulsa, OK 74136
Phone (918) 481-4700

Dept 2269
Tulsa, OK 74182

4200 E Skelly Dr
Ste 700
Tulsa, OK 74135
Phone (918) 438-7050

Dept 1038
Tulsa, OK 74182

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

326 Calhoun St
Fl 3
Charleston, SC 29425
Phone (843) 876-8340

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

326 Calhoun St
Charleston, SC 29425
Phone (843) 876-8619

1300 Hospital Dr
Ste 210
Mt Pleasant, SC 29464
Phone (803) 884-2477

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/37d0fa6b-e0f7-4581-adbb-f9e2eac855e1/
  • Direct secure messaging: cclark21981@muscogeecreeknation.direct-ci.com

Organizations & group practices 16

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.

View all 16

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1649223710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 305",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450305",
            "telephone_number": "918-481-4706",
            "fax_number": "918-481-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 S YALE AVE",
            "address_2": "SUITE 1002",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367823",
            "telephone_number": "918-481-4700",
            "fax_number": "918-481-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHRISTIAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OK",
            "license": "27511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200292330A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.