Morris Clark, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

014985 Issued in CT

Practice address

11 Grove St
Booth House
New Milford, CT 06776-3626

Phone

(860) 354-5511

Fax

(860) 350-3122

NPI assigned

May 16, 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

Medicare fee-for-service enrollment

Enrolled in NY

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

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.

• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912

  NY

  Medicare reassignment NPD
• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Brewster, NY
  • NPI 1043335284
  NPD

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1760434989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 GROVE ST",
            "address_2": "BOOTH HOUSE",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067763626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 GROVE ST",
            "address_2": "BOOTH HOUSE",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067763626",
            "telephone_number": "860-354-5511",
            "fax_number": "860-350-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MORRIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "014985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lea Chesbro
• Christina Keenan LPC LLC
• Christopher Carlone DDS PC LLC
• Edith Chu, M.D.
• Kelsey Ann Clark, RVT, RDCS
• Paloma Silva Coelho, LCSW
• Victor Isaac Cohen, MD
• Kendra Elaine Cole, MA
• Margaret E Connaghan, APRN
• Connecticut CVS Pharmacy, L.L.C.

• All providers in New Milford, CT
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.