Raymond H Clark, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

C8236 Issued in AR

Practice address

5330 Plantation CV
Conway, AR 72034-8586

Phone

(501) 472-7697

Fax

(501) 336-8837

NPI assigned

Sep 1, 2006

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 AR

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.

Enrollment records 1

Specialty

Psychiatry

Education

University of Arkansas College of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Dardanelle Regional Medical Center Hospital, Dardanelle, AR, CCN 041302

Medicare enrollment (NPD)

Enrolled

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.

• Conway Psychiatric Clinic, PLLC

  • Psychiatry Physician
  • Conway, AR
  • NPI 1972808145
  Medicare reassignment NPD Authorized official
• Conway Regional Medical Center Inc

  • General Acute Care Hospital
  • Conway, AR
  • NPI 1417024662
  Medicare reassignment NPD
• Conway Regional Medical Center Inc

  dba Conway Regional Mobile Health Unit

  • Family Medicine Physician
  • Conway, AR
  • NPI 1043183544
  NPD

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

• Dardanelle Regional, LLC

  dba Dardanelle Regional Medical Center

  • Critical Access Hospital
  • Dardanelle, AR
  • NPI 1184629594
  Care Compare affiliation

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1750483699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10705",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720340012",
            "telephone_number": "501-472-7697",
            "fax_number": "501-336-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 PLANTATION CV",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720348586",
            "telephone_number": "501-472-7697",
            "fax_number": "501-336-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "RAYMOND",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "C8236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129952001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Nicholas Clark, D.D.S.
• Kelly L Clark, PTA
• Leslea Clark, M.S.CCC-SLP
• Madelyn Clark
• Mark L Clark, PHD
• Sarah Grace Clark, DDS
• Candace Marie Clarke-Brown, AT
• Celeste A Clarke, DC
• Chantillee A Clary
• Daxton Clatworthy

• Psychiatry Physician in Conway, AR
• Providers in Conway, AR by specialty
• Psychiatry Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.