Crandon F Clark, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

L1002 Issued in TX

Practice address

1901 Medi Park
Ste 2050
Amarillo, TX 79106-2110

Phone

(806) 355-3352

NPI assigned

Mar 31, 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

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in TX, NM2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

University of Cincinnati College of Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

High Plains Radiological Association LLPGroup PAC ID 9739172479, 36 clinicians

Open Air Imaging Center LLPGroup PAC ID 9739258310, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bsa Hospital Hospital, Amarillo, TX, CCN 450231
• Lovelace Regional Hospital - Roswell Hospital, Roswell, NM, CCN 320086
• Glen Rose Medical Center Hospital, Glen Rose, TX, CCN 450451
• Childress Regional Medical Center Hospital, Childress, TX, CCN 450369
• Cogdell Memorial Hospital Hospital, Snyder, TX, CCN 451384

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cclark21087@ahs.direct-ci.com

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.

• High Plains Radiological Association LLP

  • Diagnostic Radiology Physician
  • Amarillo, TX
  • NPI 1205897360

  NM

  Medicare reassignment Care Compare group NPD
• Open Air Imaging Center, LLP

  • Radiology Clinic/Center
  • Amarillo, TX
  • NPI 1609982131
  Medicare reassignment Care Compare group NPD
• Medical Imaging of Dallas, LLP

  • Specialist
  • Irving, TX
  • NPI 1972694099
  NPD (past)
• Metroamerican Radiology Consultants P a

  • Diagnostic Radiology Physician
  • Knoxville, TN
  • NPI 1386678092
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bsa Hospital LLC

  • General Acute Care Hospital
  • Amarillo, TX
  • NPI 1407191984
  Care Compare affiliation
• Childress County Hospital District

  • General Acute Care Hospital
  • Childress, TX
  • NPI 1326079534
  Care Compare affiliation
• Childress County Hospital District

  • Clinic/Center
  • Memphis, TX
  • NPI 1477078517

  Hospital

  Care Compare affiliation
• Childress County Hospital District

  • Clinic/Center
  • Paducah, TX
  • NPI 1619493954

  Hospital

  Care Compare affiliation
• Scurry County Hospital District

  • Critical Access Hospital
  • Snyder, TX
  • NPI 1578588463
  Care Compare affiliation
• Somervell County Hospital District

  • Rural Acute Care Hospital
  • Glen Rose, TX
  • NPI 1700826575
  Care Compare affiliation
• Lovelace Health System LLC

  • General Acute Care Hospital
  • Roswell, NM
  • NPI 1972878361
  Care Compare affiliation

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1669433124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3780",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791163780",
            "telephone_number": "806-355-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MEDI PARK",
            "address_2": "STE 2050",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791062110",
            "telephone_number": "806-355-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CRANDON",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "L1002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100850140A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "130630101",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141091204",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10838058",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF TEXAS",
            "identifier": "8F7703",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "MDL1002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cindy I. Hutson, D.O., P.a.
• Stacy Cirone, RNFA
• City of Amarillo
• Abby Sabrina Clark, MD
• Anita M Clark, FNP-C
• Elizabeth Clark, MA, LPC
• Jarrod Clark, PHARMD
• Kathleen Anne Clark, M.D.
• Summer Clark, M.D.
• Terry Clark, PHARM.D.

• Diagnostic Radiology Physician in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.