Active NPI
Mark Wayne Clark, DBA MARION FAMILY
- Community/Retail Pharmacy
- Marion, AR
National Provider Identifier
1659856185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- AR20895
- Practice address
- 134 Block St
Marion, AR 72364-1956 - Phone
- (870) 739-1111
- Fax
- (870) 739-1116
- NPI assigned
- Oct 1, 2018
- Last updated
- Feb 23, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | AR20895 | AR | Primary |
Addresses
Primary practice location
134 Block St
Marion, AR 72364-1956
Mailing address
134 Block St
Marion, AR 72364-1956
Phone (870) 739-1111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0426355 | Other | NCPDP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AR20895 | AR | MD | Community/Retail Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carol Clark | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550880000000",
"number": "1659856185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "134 BLOCK ST",
"city": "MARION",
"state": "AR",
"postal_code": "723641956",
"telephone_number": "870-739-1111",
"fax_number": "870-739-1116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "134 BLOCK ST",
"city": "MARION",
"state": "AR",
"postal_code": "723641956",
"telephone_number": "870-739-1111",
"fax_number": "870-739-1116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "MARK",
"middle_name": "WAYNE",
"credential": "DBA MARION FAMILY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-10-01",
"last_updated": "2019-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "AR",
"license": "AR20895",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "0426355",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Marion, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.