Dana Gibbs Clark, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

K7021 Issued in TX

Practice address

2314 Shadydale Dr
Arlington, TX 76012-5428

Phone

(178) 988-4261

Fax

(817) 259-2613

NPI assigned

Jul 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Dr. Dana Bernice Gibbs Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cim Medical,PLLC

  • Integrative Medicine Physician
  • Southlake, TX
  • NPI 1871284380
  NPD Authorized official
• Cross Timbers ENT PLLC

  • Specialist
  • Arlington, TX
  • NPI 1073568127
  NPD (past)
• Cross Timbers ENT PLLC

  • Specialist
  • Arlington, TX
  • NPI 1659555829
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1720009236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 SHADYDALE DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760125428",
            "telephone_number": "178-988-4261",
            "fax_number": "817-259-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 SHADYDALE DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760125428",
            "telephone_number": "178-988-4261",
            "fax_number": "817-259-2613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DANA",
        "middle_name": "GIBBS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "K7021",
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "TX",
            "license": "K7021",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "K7021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153107101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "GIBBS",
            "middle_name": "BERNICE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• CK Behavioral Health Services, Inc.
• CKC Holdings LLC
• Melannie Leigh Clack, LCSW
• Rayne Eleanor Clapp
• Audrey Danay Clark
• David Roger Clark, M.D.
• John Darren Clark, MD
• Koryann Clark
• Latrece Clark
• Janeen Clark, PT, PT, DPT

• All providers in Arlington, TX
• Otolaryngology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.