Teralynn S Clark, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

4316 Issued in SD

Practice address

1201 Mickelson Dr Ste 2
Watertown, SD 57201-7253

Phone

(605) 882-0432

Fax

(605) 882-0978

NPI assigned

Jul 28, 2006

Last updated

Feb 22, 2013By the provider in NPPES

Sex

Female

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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Siouxland Anesthesiology, LTD

  • Pain Medicine (Anesthesiology) Physician
  • Dakota Dunes, SD
  • NPI 1669496337
  NPD (past)
• Watertown Anesthesia PC

  • Anesthesiology Physician
  • Watertown, SD
  • NPI 1215941117
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1699789263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 MICKELSON DR STE 2",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572017253",
            "telephone_number": "605-882-0432",
            "fax_number": "605-882-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 MICKELSON DR STE 2",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572017253",
            "telephone_number": "605-882-0432",
            "fax_number": "605-882-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TERALYNN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SD",
            "license": "4316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0007400",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "235822100",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5707122",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "59F05CL",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cedar Lakes Therapy, LLC
• Chad D. Beynon, O.D., P.C.
• Alan R Christensen, MD
• Bake G Christiansen, LMT
• City of Watertown (Watertown Fire Rescue)
• Kris Cleveland, P.T.
• Kristina Cloutier, LPC
• Codington County Auditor (Codington County Welfare Office)
• Collin C. Palmquist DDS, PC
• Comfort Bridge LLC

• Anesthesiology Physician in Watertown, SD
• Providers in Watertown, SD by specialty
• Anesthesiology Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; 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.