Active NPI
Lamont L. Clark, M.A.-CCC-SLP
- Speech-Language Pathologist
- Springfield, MO
National Provider Identifier
1790844579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 0296200
- Practice address
- 940 N Jefferson Ave
Springfield, MO 65802-3718 - Phone
- (417) 773-0384
- NPI assigned
- Dec 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 0296200 | MO | Primary |
Addresses
Primary practice location
940 N Jefferson Ave
Springfield, MO 65802-3718
Mailing address
3725 N Farm Road 79
Willard, MO 65781-8155
Phone (417) 773-0384
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0296200 | MO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790844579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3725 N FARM ROAD 79",
"city": "WILLARD",
"state": "MO",
"postal_code": "657818155",
"telephone_number": "417-773-0384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 N JEFFERSON AVE",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658023718",
"telephone_number": "417-773-0384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "LAMONT",
"middle_name": "L.",
"name_prefix": "Mr.",
"credential": "M.A.-CCC-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "0296200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.