Individual provider Active NPI

Robert John Clarke, D.C.

  • Chiropractor
  • Marysville, WA
National Provider Identifier
1831415355
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60145579 Issued in WA
Practice address
1519 9TH St
Ste 101
Marysville, WA 98270
Phone
(360) 658-5618
Fax
(360) 658-5618
NPI assigned
Apr 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH60145579 WA Primary

Addresses

Primary practice location

1519 9TH St
Ste 101
Marysville, WA 98270

Mailing address

1519 9TH St
Ste 101
Marysville, WA 98270-4600
Phone (360) 658-1987

Other names 1

  • Dr. Robert John Clarke Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100729000936 WA Practitioner - Chiropractic 9638202492 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1519 9TH St
Suite 101
Marysville, WA 98270-4600
Phone (360) 658-1987

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH60145579WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Rjciv, Inc. P.S. Chiropractor CurrentSince Jun 28, 2012 Accepting new patients

Locations

1519 9th St
Ste 101
Marysville, WA 98270
Phone (360) 658-1987

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1831415355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 9TH ST",
            "address_2": "STE 101",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704600",
            "telephone_number": "360-658-1987",
            "fax_number": "360-658-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 9TH ST",
            "address_2": "STE 101",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "98270",
            "telephone_number": "360-658-5618",
            "fax_number": "360-658-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-08",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60145579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "CLARKE",
            "middle_name": "JOHN",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Marysville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.