Individual provider Active NPI

Stephen L Clarke, DC

  • Chiropractor
  • Talbott, TN
National Provider Identifier
1972610475
Registry record updated Feb 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
TN796 Issued in TN
Practice address
6156 West Andrew Johnson Hwy
Talbott, TN 37877
Phone
(423) 581-7629
Fax
(423) 581-6551
NPI assigned
Aug 23, 2006
Last updated
Feb 24, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X TN796 TN Primary

Addresses

Primary practice location

6156 West Andrew Johnson Hwy
Talbott, TN 37877

Mailing address

PO Box 338
Talbott, TN 37877
Phone (423) 581-7629

Other identifiers 1

IdentifierTypeStateIssuer
3676064MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111221000118 TN Practitioner - Chiropractic 2264608330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6156 W Andrew Johnson Hwy
Talbott, TN 37877-8603
Phone (423) 581-7629

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
TN796TNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Center, P.C. Chiropractor CurrentSince Jan 1, 1997 Accepting new patients

Locations

6156 W Andrew Johnson Hwy
Talbott, TN 37877
Phone (423) 581-6551

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1972610475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 338",
            "city": "TALBOTT",
            "state": "TN",
            "postal_code": "37877",
            "telephone_number": "423-581-7629",
            "fax_number": "423-581-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6156 WEST ANDREW JOHNSON HWY",
            "city": "TALBOTT",
            "state": "TN",
            "postal_code": "37877",
            "telephone_number": "423-581-7629",
            "fax_number": "423-581-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "STEPHEN",
        "middle_name": "L",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "TN796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3676064",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Talbott, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; 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.