Individual provider Active NPI

Clark Harrison, MD

  • Gastroenterology Physician
  • Reno, NV
National Provider Identifier
1679559496
Registry record updated May 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
6505 Issued in NV
Practice address
880 Ryland St
Reno, NV 89502-1603
Phone
(775) 329-4600
Fax
(775) 333-2969
NPI assigned
Dec 22, 2005
Last updated
May 7, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2010

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 6505 NV Primary

Addresses

Primary practice location

880 Ryland St
Reno, NV 89502-1603

Mailing address

880 Ryland St
Reno, NV 89502-1603
Phone (775) 329-4600

Other identifiers 1

IdentifierTypeStateIssuer
2016237MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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

Enrollment IDStateProvider typePAC IDDetails
I20100621000794 NV Practitioner - GastroenterologyPractitioner - Internal Medicine 4486551926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Boston University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Consultants LTDGroup PAC ID 0941107478, 39 clinicians

Practice addresses (Care Compare)

880 Ryland St
Reno, NV 89502-1603
Phone (775) 329-4600

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy126
Upper gastrointestinal (GI) endoscopy for acid reflux79

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reno Endoscopy Center, LLC Current Accepting new patients
Gastroenterology Consultants, LTD CurrentSince Jan 1, 1987 Accepting new patients
Gastroenterology Medical Clinic CurrentSince Jul 1, 2022 Accepting new patients
Renown Regional Medical Center Past Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients
Mt Grant General Hospital Past Accepting new patients
South Meadows Endoscopy Center, LLC PastSince Aug 13, 2023 Accepting new patients

Locations

1580 Creekside Dr
Ste 220
Folsom, CA 95630
Phone (530) 295-2153

1000 Fowler Way
Ste 7
Placerville, CA 95667
Phone (530) 295-0608

10619 Professional Cir
Reno, NV 89521
Phone (775) 329-4600

880 Ryland St
Reno, NV 89502
Phone (775) 329-4600

Interoperability endpoints

  • Direct secure messaging: charrison@directaddress.net

Organizations & group practices 8

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273190400000",
    "number": "1679559496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 RYLAND ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021603",
            "telephone_number": "775-329-4600",
            "fax_number": "775-333-2969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 RYLAND ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021603",
            "telephone_number": "775-329-4600",
            "fax_number": "775-333-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "CLARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2010-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NV",
            "license": "6505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2016237",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.