John Clark, RN

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

RN629103 Issued in CA

Practice address

52 N Tu Su LN
Bishop, CA 93514-8058

Phone

(760) 873-8461

Fax

(760) 873-3530

NPI assigned

Jan 23, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Toiyabe Indian Health Project, Inc

  • Clinic Pharmacy
  • Bishop, CA
  • NPI 1093720609
  NPD (past)
• Toiyabe Indian Health Project, Inc

  • Federally Qualified Health Center (FQHC)
  • Bishop, CA
  • NPI 1659433191
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689728032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 24R",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935149610",
            "telephone_number": "760-387-2187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 N TU SU LN",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935148058",
            "telephone_number": "760-873-8461",
            "fax_number": "760-873-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "RN629103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATION NPI #",
            "identifier": "1659433191",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda M Christensen, LCSW
• Kathleen Citrenbaum, LCSW
• City of Bishop (Bishop Fire Department)
• Dolphe Scott Clark, M.D.
• Janelle Clark
• Savannah Faye Cole, LMFT
• Connie Lou Connolly, R.N.
• Grace Cook, PH.D., M.F. T.
• Yolanda Cortez
• Carri Dawn Coudek

• General Practice Registered Nurse in Bishop, CA
• Providers in Bishop, CA by specialty
• General Practice Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.