Active NPI
Christopher Robin Clark, M.D.
- Hospitalist Physician
- Springdale, AR
National Provider Identifier
1669614871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- E7642
- Practice address
- 609 W Maple Ave
Springdale, AR 72764-5335 - Phone
- (479) 757-5285
- Fax
- (479) 757-2977
- NPI assigned
- Apr 2, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | E-7642 | AR | |
| Hospitalist Physician | 208M00000X | E7642 | AR | Primary |
Addresses
Primary practice location
609 W Maple Ave
Springdale, AR 72764-5335
Mailing address
601 W Maple Ave
Springdale, AR 72764-5335
Phone (479) 757-5285
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121004000656 | AR | Practitioner - Internal Medicine | 4880843960 | Reassigns benefits to 3 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Health Northwest Arkansas Communities
Practice addresses (Care Compare)
2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone (479) 338-8000
Hospital & facility affiliations
- Mercy Hospital Northwest Arkansas
- Mercy Hospital Berryville
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E7642 | AR | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health Northwest Arkansas Communities | Current | Accepting new patients | |
| Mercy Health Northwest Arkansas Communities | Hospitalist | Current | Accepting new patients |
| Mercy Hospital Berryville | Current | Accepting new patients | |
| Mercy Hospital Rogers | Past | Accepting new patients |
Locations
3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100
214 Carter St
Berryville, AR 72616
Phone (870) 423-3355
2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000
Organizations & group practices 7
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.
-
- Hospitalist Physician
- Rogers, AR
- NPI 1699076737
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- NPI 1508167677
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- General Acute Care Hospital
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Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360627200000",
"number": "1669614871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 W MAPLE AVE",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727645335",
"telephone_number": "479-757-5285",
"fax_number": "479-757-2977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "609 W MAPLE AVE",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727645335",
"telephone_number": "479-757-5285",
"fax_number": "479-757-2977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "CHRISTOPHER",
"middle_name": "ROBIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-02",
"last_updated": "2013-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AR",
"license": "E-7642",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "AR",
"license": "E7642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; 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.