NPIMap

Organization Active NPI

Clark Chiropractic Center, Inc.

  • Chiropractor
  • Pasadena, MD
National Provider Identifier
1710025200
Registry record updated Nov 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1464PT Issued in MD
Legal business name
CLARK CHIROPRACTIC CENTER, INC.
Practice address
4639 Mountain Rd
Pasadena, MD 21122-5455
Phone
(443) 637-4936
Fax
(443) 637-4946
NPI assigned
Feb 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Steven E. Clark, D.C.
Title
Ceo
Phone
(443) 637-4936

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1464PT MD Primary

Addresses

Primary practice location

4639 Mountain Rd
Pasadena, MD 21122-5455

Mailing address

4639 Mountain Rd
Pasadena, MD 21122-5455
Phone (443) 637-4936

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227139200000",
    "number": "1710025200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4639 MOUNTAIN RD",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211225455",
            "telephone_number": "443-637-4936",
            "fax_number": "443-637-4946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4639 MOUNTAIN RD",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211225455",
            "telephone_number": "443-637-4936",
            "fax_number": "443-637-4946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK CHIROPRACTIC CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2008-11-20",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-637-4936",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "1464PT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; 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.