William F Clark, D.C.

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

001321 Issued in CT

Practice address

154 West St
Suite E
Cromwell, CT 06416-4400

Phone

(860) 632-1668

Fax

(860) 632-1672

NPI assigned

Oct 17, 2006

Last updated

Feb 1, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 12

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Clark Chiropractic Center, LLC

  • Rehabilitation Chiropractor
  • Cromwell, CT
  • NPI 1548532831
  Authorized official Same address or phone
• Connecticut Spine & Sports Medicine

  • Physical Therapist
  • Middletown, CT
  • NPI 1548464530
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1740360049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 WEST ST",
            "address_2": "SUITE E",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064164400",
            "telephone_number": "860-632-1668",
            "fax_number": "860-632-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 WEST ST",
            "address_2": "SUITE E",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064164400",
            "telephone_number": "860-632-1668",
            "fax_number": "860-632-1672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "WILLIAM",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CT",
            "license": "001321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN AMERICAN CHIROPRACTIC NETWORK",
            "identifier": "611244",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SHIELD",
            "identifier": "050001321CT02",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WEBSTER",
            "identifier": "U75980",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AIG",
            "identifier": "1397991",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "44-04334",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GAB ROBBINS",
            "identifier": "U75980",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIBERTY MUTUAL",
            "identifier": "U75980",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMC HEALTH MANAGEMENT CENTER",
            "identifier": "U75980",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "132100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS PRIVATE HEALTHCARE SYSTEMS",
            "identifier": "905871CONN",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2773574",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7139035",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryleigh Christianson
• Diana Christie
• Jennifer Lynn Chrzanowski
• Kaitlyn Clancy, M.ED
• Clark Chiropractic Center, LLC
• Patricia Ellen Clarke
• Carol Louise Pear Cleveland, OTR
• Gwendolyn D Coachman
• Coherent Eye Care, LLC
• Jennifer Colello

• Rehabilitation Chiropractor in Cromwell, CT
• Providers in Cromwell, CT by specialty
• Rehabilitation Chiropractor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.