Gregory P Clark, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

203 Issued in WY

Practice address

777 Avenue H
Powell Valley Healthcare Inc
Powell, WY 82435

Phone

(307) 754-3405

Fax

(307) 754-1207

NPI assigned

Oct 31, 2005

Last updated

May 13, 2015By the provider in NPPES

Sex

Male

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 WY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Holistic Pain Management of Wyoming LLCGroup PAC ID 0840621322, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Powell Valley Hospital Hospital, Powell, WY, CCN 531310
• Cody Regional Health Hospital, Cody, WY, CCN 531312
• North Big Horn Hospital District Hospital, Lovell, WY, CCN 531309

Merit-based Incentive Payment System (MIPS)

Final score

82.54 of 100Reported as group

Quality

71.68

Promoting interoperability

100

Improvement activities

40

Cost

70.14

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gclark@powellvalleyhealthcare.cernerdirect.com

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.

• Holistic Pain Management of Wyoming, LLC

  • Family Nurse Practitioner
  • Riverton, WY
  • NPI 1487295846
  Medicare reassignment Care Compare group
• Powell Valley Healthcare Inc

  dba Powell Valley Clinic

  • Family Medicine Physician
  • Powell, WY
  • NPI 1699721316
  Medicare reassignment NPD
• Powell Valley Health Care Inc

  • Critical Access Hospital
  • Powell, WY
  • NPI 1497753115
  NPD
• William H and Carrie Gottsche Foundation

  dba Gottsche Rehabilitation Center

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Thermopolis, WY
  • NPI 1558319392
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cody Regional Health EMS

  • Land Ambulance
  • Cody, WY
  • NPI 1366432197

  Hospital

  Care Compare affiliation
• North Big Horn Hospital District

  • Critical Access Hospital
  • Lovell, WY
  • NPI 1952379547
  Care Compare affiliation
• Powell Valley Health Care Inc

  • Critical Access Hospital
  • Powell, WY
  • NPI 1497753115
  Care Compare affiliation
• West Park Hospital District

  dba Cody Regional Health

  • Critical Access Hospital
  • Cody, WY
  • NPI 1558351536
  Care Compare affiliation

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431475200000",
    "number": "1730170796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 AVENUE H",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "82435",
            "telephone_number": "307-754-3405",
            "fax_number": "307-754-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 AVENUE H",
            "address_2": "POWELL VALLEY HEALTHCARE INC",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "82435",
            "telephone_number": "307-754-3405",
            "fax_number": "307-754-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "GREGORY",
        "middle_name": "P",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2015-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115812100",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Christensen
• Kelly E Christensen, M.D.
• Chrysalis Treatment Center, Inc.
• Alexander G. Cianflone, MD
• Erica Lee Clark
• Sara Clark, DPT
• Peggy Clarke
• Jenkins Lucas Clarkson, MD
• Cloud Peak Counseling Center (Oxbow Center)
• Carletta Collins, MD

• Physician Assistant in Powell, WY
• Providers in Powell, WY by specialty
• Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.