Eric M Clark, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5077 Issued in CO

Practice address

500 San Juan St
Trinidad, CO 81082-2517

Phone

(719) 845-0001

Fax

(719) 845-8882

NPI assigned

Nov 29, 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 CO

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 1999

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Clark Family Chiropractic Inc

  • Chiropractor
  • Trinidad, CO
  • NPI 1629281001
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780751453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SAN JUAN ST",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822517",
            "telephone_number": "719-845-0001",
            "fax_number": "719-845-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SAN JUAN ST",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822517",
            "telephone_number": "719-845-0001",
            "fax_number": "719-845-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ERIC",
        "middle_name": "M",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles F Yeagle, MD, PC
• Joyce Chavez, MT
• Charla A Chenoweth-Swift, LCSW
• Gerald Anthony Cichocki, M.D.
• Clark Family Chiropractic Inc
• Cobigred Inc
• Collective Healing Institute
• Colorado Occupational and Lymphedema Therapy LLC
• Comprehensive Dentistry PC
• James Andrew Conrad, M.D.

• Chiropractor in Trinidad, CO
• Providers in Trinidad, CO by specialty
• Chiropractor in Colorado

• 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.
• 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.