Elizabeth B Clarke, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

05108TG Issued in TX

Practice address

4314 Kemp Blvd
Wichita Falls, TX 76308

Phone

(940) 691-5645

Fax

(940) 691-5653

NPI assigned

Feb 20, 2007

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 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of Houston - College of Optometry, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clarke Eyecare Center LLPGroup PAC ID 1052461944, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Clarke Eyecare Center, LLP

  • Optometrist
  • Wichita Falls, TX
  • NPI 1730398306
  Medicare reassignment Care Compare group NPD
• Optio, PLLC

  • Audiologist
  • Southlake, TX
  • NPI 1154888196

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299715200000",
    "number": "1720123441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4314 KEMP BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763083716",
            "telephone_number": "940-691-5645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4314 KEMP BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "76308",
            "telephone_number": "940-691-5645",
            "fax_number": "940-691-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "ELIZABETH",
        "middle_name": "B",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2011-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "05108TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "81141E",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Clark, LVN
• Nicole Lee Clark
• Clarke Eyecare Center, LLP
• Calvin S Clarke, OD
• Daniel B Clarke, OD
• Gracie Clarke, LCSW
• Thomas J Cleary, LCSW
• Allison E Clement, PTA
• Miranda June Clemons, PMHNP
• Clindle LLC

• Optometrist in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.