Steven Allen Clark, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

36994 Issued in MN

Practice address

5435 Feltl Rd
Minnetonka, MN 55343-7983

Phone

(952) 835-9880

NPI assigned

Jul 27, 2006

Last updated

Mar 17, 2018By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1801800032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5435 FELTL RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553437983",
            "telephone_number": "952-835-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5435 FELTL RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553437983",
            "telephone_number": "952-835-9880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 south dellwood",
            "address_purpose": "LOCATION",
            "city": "cambridge",
            "state": "MN",
            "postal_code": "550081920",
            "country_code": "US",
            "telephone_number": "763-689-7700 x1128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "STEVEN",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "36994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "829725800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Citadel Southwest Commons LLC
• Angela M Clapp, FNP-BC
• Diane Maxine Clark, PT
• Kaulette Clark
• Pontris Sapp Clark, NURSE PRACTITIONER
• Jazmin Clausen-Thomas
• Kendall Marie Clausen
• Monica Clayton
• Darla Cleary, MA, LPCC
• Deborah Jean Clemmensen, M.EQ.

• Emergency Medicine Physician in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Emergency Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.