Jason Craig Clark, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

036125628 Issued in IL

Practice address

520 Valley View Dr
Moline, IL 61265-6194

Phone

(309) 762-3621

Fax

(309) 762-3690

NPI assigned

Nov 1, 2006

Last updated

Dec 6, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA, IL2 enrollments

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 2

Specialty

Orthopedic Surgery

Education

University of Iowa, RJ & L Carver College of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Physical Therapy Services, LTD.Group PAC ID 9133101462, shared by 5 NPIs, 216 clinicians

Ora Orthopedics PCGroup PAC ID 6406741784, 119 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Rock Island Hospital, Rock Island, IL, CCN 140280
• Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275
• MC Donough District Hospital Hospital, Macomb, IL, CCN 140089
• Trinity - Bettendorf Hospital, Bettendorf, IA, CCN 160104
• Genesis Medical Center, Aledo Hospital, Aledo, IL, CCN 141304

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jclark92158@direct.unitypoint.org
• Direct secure messaging: jclark@ora2099.srs-direct.com

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.

• Ora Orthopedics PC

  • Orthopaedic Surgery Physician
  • Moline, IL
  • NPI 1962481861

  IA

  Medicare reassignment Care Compare group NPD
• Ora Orthopedics, PC

  • Orthopaedic Surgery Physician
  • De Witt, IA
  • NPI 1043281355
  NPD
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Advanced Radiology, S.C.

  • Diagnostic Radiology Physician
  • Rock Island, IL
  • NPI 1790773539
  NPD (past)
• Genortho, LLC

  dba Crow Valley Orthopaedic Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Bettendorf, IA
  • NPI 1528142726
  NPD (past)
• Ora Orthopedics, PC

  • Orthopaedic Surgery Physician
  • Durant, IA
  • NPI 1639159700
  NPD (past)

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

• Genesis Health System

  dba Genesis Medical Center - Silvis

  • General Acute Care Hospital
  • Silvis, IL
  • NPI 1427132604
  Care Compare affiliation
• Genesis Medical Center, Aledo

  • Critical Access Hospital
  • Aledo, IL
  • NPI 1225380967
  Care Compare affiliation
• McDonough County Hospital District

  dba McDonough District Hospital

  • General Acute Care Hospital
  • Macomb, IL
  • NPI 1669420766
  Care Compare affiliation
• Trinity Medical Center

  dba Trinity Rock Island

  • General Acute Care Hospital
  • Rock Island, IL
  • NPI 1316047632
  Care Compare affiliation
• Trinity Medical Center

  dba Trinity Bettendorf

  • General Acute Care Hospital
  • Bettendorf, IA
  • NPI 1124110820
  Care Compare affiliation

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291593600000",
    "number": "1811075856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 VALLEY VIEW DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656194",
            "telephone_number": "309-762-3621",
            "fax_number": "309-762-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 VALLEY VIEW DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656194",
            "telephone_number": "309-762-3621",
            "fax_number": "309-762-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JASON",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2010-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "TRN7762",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IA",
            "license": "38994",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036125628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036125628",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie Ann Christenson
• John C Ciaccio, MD
• Natalie Circello
• City of Moline
• Charmaine Clark
• Rebekah Ann Clark, LPHA,LCSW
• Mara M Clarke, NPC
• Diann M Clem, DPT
• Ann Katherine Cobb, CCC/SLP
• Robert Cobert, APN

• Orthopaedic Surgery Physician in Moline, IL
• Providers in Moline, IL by specialty
• Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.

Verify at the official NPI Registry.