Christine Caron Clark, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

8702 Issued in NV

Practice address

2421 Tech Center CT
#108
Las Vegas, NV 89128

Phone

(702) 642-4405

Fax

(702) 642-6775

NPI assigned

Jul 7, 2006

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

Medicare fee-for-service enrollment

Enrolled in NV

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

Medicare enrollment (NPD)

Enrolled

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.

• Christine C Clark LTD

  • Podiatrist
  • Las Vegas, NV
  • NPI 1841649779
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770515967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34844",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891330844",
            "telephone_number": "702-642-4405",
            "fax_number": "702-642-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 TECH CENTER CT",
            "address_2": "#108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89128",
            "telephone_number": "702-642-4405",
            "fax_number": "702-642-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHRISTINE",
        "middle_name": "CARON",
        "name_prefix": "Ms.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NV",
            "license": "8702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Clark, PA-C
• Carrien Patricia Clark
• Charlene Renee Clark
• Chavaughnda Jean Clark
• Chong Hui Clark
• Chunzell Clark
• Coi Clark
• Connie Clark
• Cornell M Clark, M.D.
• Dallas Clark

• Podiatrist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Podiatrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.