NPIMap

Organization Active NPI

DRS. McClow, Clark & Berk PA

Doing business as MCB Radiology

  • Diagnostic Radiology Physician
  • Jacksonville Beach, FL
National Provider Identifier
1871166975
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
DRS. MCCLOW, CLARK & BERK PA
Doing business as
MCB Radiology
Practice address
3316 3Rd St S Ste 101
Jacksonville Beach, FL 32250-6090
Phone
(904) 241-7772
NPI assigned
Jul 19, 2021
Last updated
Aug 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Authorized official

Name
Dr. Ario Rezaei, MDNPI 1417158452
Title
President
Phone
(904) 388-6949

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

3316 3Rd St S Ste 101
Jacksonville Beach, FL 32250-6090

Mailing address

PO Box 161180
Altamonte Springs, FL 32716-1180

Other names 1

  • MCB Radiology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
DRS McClow Clark Berk PA14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1871166975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 161180",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327161180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 3RD ST S STE 101",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506090",
            "telephone_number": "904-241-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. MCCLOW, CLARK & BERK PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-19",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "REZAEI",
        "authorized_official_first_name": "ARIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-388-6949",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCB Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.