Active NPI
Trent Murray Clark, DO
- Pediatrics Physician
- Memphis, TN
National Provider Identifier
1821794587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 1821794587
- Practice address
- 920 Madison Ave Ste 447
Memphis, TN 38103-3438 - Phone
- (901) 287-6756
- NPI assigned
- Feb 3, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 1821794587 | TX | Primary |
Addresses
Primary practice location
920 Madison Ave Ste 447
Memphis, TN 38103-3438
Mailing address
920 Madison Ave Ste 447
Memphis, TN 38103-3438
Phone (901) 287-6756
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250508000585 | TX | Order and Referring Only - Pediatric Medicine | 9335666825 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1821794587 | TX | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745798400000",
"number": "1821794587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 MADISON AVE STE 447",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381033438",
"telephone_number": "901-287-6756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 MADISON AVE STE 447",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381033438",
"telephone_number": "901-287-6756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "TRENT",
"middle_name": "MURRAY",
"name_prefix": "Mr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-03",
"last_updated": "2025-04-28",
"certification_date": "2025-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "1821794587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.