Stuart G. Clark V, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

302997 Issued in LA

Practice address

1501 Kings Hwy
Dept. of Pediatrics
Shreveport, LA 71103-4228

Phone

(318) 675-8600

NPI assigned

Apr 11, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sclark1416923@direct.ochsner.org

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.

• Convenient Care LLC

  • Urgent Care Clinic/Center
  • Baton Rouge, LA
  • NPI 1164422630

  LA

  Medicare reassignment NPD
• Coolidge Emergency Group LLC

  • Emergency Medicine Physician
  • Lafayette, LA
  • NPI 1801140934

  LA

  Medicare reassignment NPD
• Lourdes After Hours LLC

  • Urgent Care Clinic/Center
  • Lafayette, LA
  • NPI 1649297730

  LA

  Medicare reassignment NPD
• Convenient Care LLC

  • Urgent Care Clinic/Center
  • Hammond, LA
  • NPI 1225119225
  NPD
• Convenient Care LLC

  • Urgent Care Clinic/Center
  • Baton Rouge, LA
  • NPI 1497848477
  NPD
• Lourdes After Hours LLC

  • Urgent Care Clinic/Center
  • Carencro, LA
  • NPI 1669774923
  NPD
• Pediatric Associates of Lafayette, LLC

  • Specialist
  • Lafayette, LA
  • NPI 1881641447
  NPD (past)

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1831532555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "address_2": "DEPT. OF PEDIATRICS",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "address_2": "DEPT. OF PEDIATRICS",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "STUART",
        "middle_name": "G.",
        "name_suffix": "V",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-11",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "302997",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip Clark
• Porsha Lynniece Clark
• Shamika Clark
• Shanika Clark
• Stephen W. Clark, CRNA
• Teresa Octavia Clark, QP
• Shemekia Clarkson
• Claude Lockhart MD and Willis-Knighton Medical Center
• Dana Carol Clawson, NP
• Rebecca Eskew Clawson, PA

• All providers in Shreveport, LA
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.

Verify at the official NPI Registry.