Clark Chiropractic Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2111 Issued in MA

Legal business name

CLARK CHIROPRACTIC INC.

Practice address

69 Willard St
Quincy, MA 02169-1228

Phone

(617) 479-2400

NPI assigned

Apr 5, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert J Clark, D.C.NPI 1982781258

Title

Owner

Phone

(617) 479-2400

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert J Clark, D.C.

  • Chiropractor
  • Quincy, MA
  • NPI 1982781258
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1175731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851413298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 WILLARD ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021691228",
            "telephone_number": "617-479-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 WILLARD ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021691228",
            "telephone_number": "617-479-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK CHIROPRACTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-479-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "Y40011",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS GROUP #",
            "identifier": "648938",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP GROUP #",
            "identifier": "0039113",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mengche Chung, D.D.S.
• Schneider Cineus
• City of Quincy
• City of Quincy
• Lawrence J Civale, LICSW
• Kathleen Michelle Clark, MA, LMHC
• Robert J Clark, D.C.
• Amatoritsero Clarke
• Kathleen Monica Cleary, O.D.
• Haley Clifford

• Chiropractor in Quincy, MA
• Providers in Quincy, MA by specialty
• Chiropractor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.