Hollis J Clark, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25837 Issued in KY

Practice address

1000 S 12TH St
Murray, KY 42071-9303

Phone

(270) 759-9200

Fax

(270) 759-9966

NPI assigned

Nov 11, 2005

Last updated

Oct 16, 2015By the provider in NPPES

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 KY

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

Specialty

Internal Medicine

Education

University of Tennessee, HSC, College of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

VMD Primary Providers Central KentuckyGroup PAC ID 6709119068, 44 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• VMD Primary Providers Central Kentucky

  • Internal Medicine Physician
  • Murray, KY
  • NPI 1831674654
  Medicare reassignment Care Compare group NPD
• VMD Primary Providers Central Kentucky

  dba FIMA Medical Group

  • Rural Health Clinic/Center
  • Lebanon, KY
  • NPI 1063120194

  Internal Medicine

  NPD

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444953600000",
    "number": "1790766178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 S 12TH ST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420719303",
            "telephone_number": "270-759-9200",
            "fax_number": "270-759-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S 12TH ST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420719303",
            "telephone_number": "270-759-9200",
            "fax_number": "270-759-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "HOLLIS",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2015-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "25837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica A Champion, LPCC
• Raymond J Charette, M.D.
• Charles D. Tucker, M.D., PSC (Murray Surgery Center)
• Mary Elisabeth Chase, D.C.
• Ryan Wesley Chasseur, PHARMD
• Nathan Blaine Clark, APRN
• Tia A Clark, APRN, FNP-C
• Jacob Clevenger, OTR/L
• Aliya Grace Clough, CCC-SLP
• Chadwick Hunter Cochran, PHARM.D.

• Internal Medicine Physician in Murray, KY
• Providers in Murray, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.
• 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.