Russell Patrick Clark, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

10404 Issued in NV

Practice address

6900 N Pecos Rd
North Las Vegas, NV 89086-4400

Phone

(702) 791-9000

NPI assigned

Aug 11, 2005

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

Other identifiers 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Tulane University School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hoover Emergency Physicians LLCGroup PAC ID 0648450296, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boulder City Hospital Hospital, Boulder City, NV, CCN 291309

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.

• Hoover Emergency Physicians LLC

  • Emergency Medicine Physician
  • Boulder City, NV
  • NPI 1063713790
  Medicare reassignment Care Compare group NPD
• Fremont Emergency Services Scherr LTD

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1679550149
  Medicare reassignment NPD
• Fremont Emergency Services Scherr LTD

  • Emergency Medicine Physician
  • North Las Vegas, NV
  • NPI 1316488141
  NPD
• Fremont Emergency Services Scherr LTD

  • Emergency Medicine Physician
  • Henderson, NV
  • NPI 1689013161
  NPD
• Brown, Calvanese, Cameron LTD

  • Emergency Medicine Physician
  • Reno, NV
  • NPI 1275568479
  NPD (past)
• CTH Physicians Clinic

  • Internal Medicine Physician
  • Carson City, NV
  • NPI 1306533732
  NPD (past)
• California Em-I Medical Services, a Medical Corporation

  • Emergency Medicine Physician
  • King City, CA
  • NPI 1659320893
  NPD (past)
• Grossmont Emergency Medical Group

  • Emergency Medicine Physician
  • La Mesa, CA
  • NPI 1861437501
  NPD (past)

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

• Boulder City Hospital Inc

  • Critical Access Hospital
  • Boulder City, NV
  • NPI 1881739613
  Care Compare affiliation

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1790787497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 N PECOS RD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890864400",
            "telephone_number": "702-791-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 N PECOS RD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890864400",
            "telephone_number": "702-791-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "RUSSELL",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "10404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100504837",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lyvette Clark
• Mary Esther Clark
• Misty Clark
• Nicole Clark, LDO
• Rochelle Clark
• Shari Claros, DMD
• Mary Janine Clayton
• Lynn Louise Cleary, LCSW
• Cindy L Clements-Miller, LCSW
• Magda Clements

• Emergency Medicine Physician in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Emergency Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.