Sallie Brooks Clark, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

29564 Issued in CO

Practice address

1421 S Potomac St Ste 220
Aurora, CO 80012

Phone

(303) 337-5600

Fax

(303) 337-7734

NPI assigned

Jul 1, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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.

• Colorado Surgical and Critical Care Associates PLLC

  • Surgery Physician
  • Aurora, CO
  • NPI 1295846426
  Medicare reassignment NPD
• Surgical Consultants of Aurora PC

  • Surgery Physician
  • Aurora, CO
  • NPI 1326582032
  NPD

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1780681999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 S POTOMAC ST STE 220",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800124512",
            "telephone_number": "303-337-5600",
            "fax_number": "303-337-7734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 S POTOMAC ST STE 220",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80012",
            "telephone_number": "303-337-5600",
            "fax_number": "303-337-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SALLIE",
        "middle_name": "BROOKS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-01",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "29564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01295641",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Anne Clark, PHARM D
• Meredith Rose Clark
• Randall Clark, MD
• Richard Todd Clark, M.D.
• Riley Elizabeth Clark
• Sarah E Clark, PHD
• Sophie E Clark, MD
• Timothy Clark
• Toshimasa James Clark, M.D.
• Tracey Ann Clark, M.D.

• Surgery Physician in Aurora, CO
• Providers in Aurora, CO by specialty
• Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.