NPIMap

Individual provider Active NPI

Larry Edward Clark Jr., M.D.

  • Gastroenterology Physician
  • Lynchburg, VA
National Provider Identifier
1780659508
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101231402 Issued in VA
Practice address
121 Nationwide Dr
Suite a
Lynchburg, VA 24502-4272
Phone
(434) 384-1862
Fax
(434) 384-7704
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 0101231402 VA Primary

Addresses

Primary practice location

121 Nationwide Dr
Suite a
Lynchburg, VA 24502-4272

Mailing address

121 Nationwide Dr
Suite a
Lynchburg, VA 24502-4272
Phone (434) 384-1862

Other identifiers 1

IdentifierTypeStateIssuer
010149002MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050906001063 VA Practitioner - GastroenterologyPractitioner - Internal Medicine 0941232482 Reassigns benefits to 1 organization
I20161014001969 WV Practitioner - Gastroenterology 0941232482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Medical College of Georgia School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Assoc of Central Virginia Inc.Group PAC ID 1951331131, 23 clinicians

Practice addresses (Care Compare)

121 Nationwide Dr
Suite a
Lynchburg, VA 24502-4272
Phone 4343841862643

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.67 of 100Reported as group
Quality
90.58
Promoting interoperability
98
Improvement activities
40
Cost
86.66

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy200
Upper gastrointestinal (GI) endoscopy for acid reflux90

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Greenbrier Clinic Surgery Center Current Accepting new patients
Gastroenterology Assoc of Central Virginia Inc Gastroenterology CurrentSince Aug 1, 2005 Accepting new patients

Locations

121 Nationwide Dr
Lynchburg, VA 24502
Phone (434) 384-1862

121 Nationwide Dr
Ste A
Lynchburg, VA 24502
Phone (434) 384-1862

40823 Midland Trl E
Wht Sphr Spgs, WV 24986
Phone (304) 536-4870

Interoperability endpoints

  • Direct secure messaging: larry.clark.2@6482.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1780659508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 NATIONWIDE DR",
            "address_2": "SUITE A",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245024272",
            "telephone_number": "434-384-1862",
            "fax_number": "434-384-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 NATIONWIDE DR",
            "address_2": "SUITE A",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245024272",
            "telephone_number": "434-384-1862",
            "fax_number": "434-384-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LARRY",
        "middle_name": "EDWARD",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101231402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010149002",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.