Active NPI
Spencer A. Clarke, M.D.
- Family Medicine Physician
- Lakeview, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD21779
- Practice address
- 624 S J St
Lakeview, OR 97630-1680 - Phone
- (541) 947-3366
- Fax
- (541) 947-4404
- NPI assigned
- Dec 23, 2005
- Last updated
- Jul 21, 2010
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD21779 | OR | Primary |
Addresses
Primary practice location
624 S J St
Lakeview, OR 97630-1680
Mailing address
624 S J St
Lakeview, OR 97630-1680
Phone (541) 947-3366
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 134017 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Oregon Health Sciences University School of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lake Health District
Practice addresses (Care Compare)
557 W Washington St
Burns, OR 97720-1441
Phone (541) 573-7281
700 S J St
Lakeview, OR 97630-1623
Phone (541) 947-2114
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.71 of 100
- Quality
- 71.18
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21779 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harney District Hospital | Current | Accepting new patients | |
| Harney District Hospital | Current | Accepting new patients | |
| Lake Health District | Past | Accepting new patients |
Locations
557 W Washington St
Burns, OR 97720
Phone (541) 573-3682
559 W Washington St
Burns, OR 97720
Phone (541) 573-2074
Interoperability endpoints
- sclarke19102@secure.stcharleshealthcare.org
Organizations & group practices 4
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.
-
- Critical Access Hospital
- Burns, OR
- NPI 1285742338
-
dba Lake District Hospital
- Critical Access Hospital
- Lakeview, OR
- NPI 1376698522
-
dba NewSun Energy & Harney District Hospital Specialty Care
- Multi-Specialty Clinic/Center
- Burns, OR
- NPI 1972113306
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba NW High Desert Sleep Center Bend
- Sleep Disorder Diagnostic Clinic/Center
- Bend, OR
- NPI 1164675963
Hospital
-
- Critical Access Hospital
- Burns, OR
- NPI 1285742338
-
dba NewSun Energy & Harney District Hospital Specialty Care
- Multi-Specialty Clinic/Center
- Burns, OR
- NPI 1972113306
Hospital
-
dba St. Charles Bend
- General Acute Care Hospital
- Bend, OR
- NPI 1982621447
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279670400000",
"number": "1801873591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "624 S J ST",
"city": "LAKEVIEW",
"state": "OR",
"postal_code": "976301680",
"telephone_number": "541-947-3366",
"fax_number": "541-947-4404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "624 S J ST",
"city": "LAKEVIEW",
"state": "OR",
"postal_code": "976301680",
"telephone_number": "541-947-3366",
"fax_number": "541-947-4404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARKE",
"first_name": "SPENCER",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-23",
"last_updated": "2010-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD21779",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "134017",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakeview, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.