Ronald Larson Clarke, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD16593 Issued in OR

Practice address

14279 Glen Oak Rd
Oregon City, OR 97045-8008

Phone

(503) 657-7629

Fax

(503) 557-8651

NPI assigned

Jun 2, 2006

Last updated

Dec 11, 2012By 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1699712000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5178 NELCO CT",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970682906",
            "telephone_number": "503-557-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14279 GLEN OAK RD",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970458008",
            "telephone_number": "503-657-7629",
            "fax_number": "503-557-8651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "RONALD",
        "middle_name": "LARSON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD16593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "67972000",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009496",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clackamas County Social Services Div
• Clackamas Surgical Associates, Inc.
• Clackamas Women's Services
• Clackamette Chiropractic PC
• Carly Rayne Clark, LPC
• Tiffani Rene Clausen
• Jennifer Ann Clay
• Paul K Clem
• Tresa Clemmer
• Allyson C Clemmons, LCSW

• Pediatrics Physician in Oregon City, OR
• Providers in Oregon City, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; 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.