Clinton H Clark, DPM
Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Meridian, ID
NPI 1710924345 · NPPES record last updated Feb 21, 2014
Key facts
- NPI
- 1710924345
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- P191 (ID)
- Practice address
- 520 S Eagle Rd
Ste 1243
Meridian, ID 83642-6351 - Phone
- (208) 938-4670
- NPI assigned
- Jun 1, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.3 of 100
- Quality
- 81.29
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.37
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 97 | HI | MD | Physical Therapy Assistant |
Interoperability endpoints
- cclark18712@direct.slhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | P191 | ID | Yes |
Addresses
Primary practice location
520 S Eagle Rd
Ste 1243
Meridian, ID 83642-6351
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2222
Other providers in Meridian, ID
- Samantha Paige Cimino
- Citadel Mental Health LLC
- Cynthia Rae Clapper
- Zachary Clare
- Bailee Ann Clark
- Jeremiah Robins Clark
- Craig Douglass Clayton II
- Clear Mind Idaho LLC
- Lindsay Frame Cleary
- Meadow Marie Clerico
All providers in Meridian, ID · Foot & Ankle Surgery Podiatrist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.