Christine C Clark LTD

Primary specialty

PodiatristTaxonomy code 213E00000X

License

NV8702 Issued in NV

Legal business name

CHRISTINE C CLARK LTD

Practice address

2441 Tech Center CT
#103
Las Vegas, NV 89128-0804

Phone

(702) 642-4405

Fax

(702) 642-6775

NPI assigned

Jun 10, 2016

Organization subpart

No

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

Authorized official

Name

Christine Caron Clark, DPMNPI 1770515967

Title

Owner

Phone

(702) 642-4405

Specialties & licenses 1

Addresses

Other names 1

• The Foot Doctor Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christine Caron Clark, DPM

  • Podiatrist
  • Las Vegas, NV
  • NPI 1770515967
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465862400000",
    "number": "1841649779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 TECH CENTER CT",
            "address_2": "#103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280804",
            "telephone_number": "702-642-4405",
            "fax_number": "702-642-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 TECH CENTER CT",
            "address_2": "#103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280804",
            "telephone_number": "702-642-4405",
            "fax_number": "702-642-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTINE C CLARK LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-10",
        "last_updated": "2016-06-14",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "CARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-642-4405",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NV",
            "license": "NV8702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Foot Doctor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nonieshawana A Christie, CSFA
• Christina Lewis DDS PC
• Christina Oliver, PLLC
• Christina Parise, LLC
• Christina Stranges
• Christine Hazel Zinn
• Christine M. Formica
• Christine Navales DDS a Professional Corporation
• Christine Navales DDS a Professional Corporation
• Christine Navales DDS a Professional Corporation

• Podiatrist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Podiatrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.