Robert J Clark, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2111 Issued in MA

Practice address

69 Willard St
Quincy, MA 02169-1228

Phone

(617) 479-2400

Fax

(617) 479-2828

NPI assigned

Nov 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Clark Chiropractic Inc.

  • Chiropractor
  • Quincy, MA
  • NPI 1851413298
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982781258",
    "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",
            "fax_number": "617-479-2828"
        },
        {
            "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",
            "fax_number": "617-479-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "792893",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "0022022",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "351264",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "Y36490",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• City of Quincy
• City of Quincy
• Lawrence J Civale, LICSW
• Clark Chiropractic Inc.
• Kathleen Michelle Clark, MA, LMHC
• Amatoritsero Clarke
• Kathleen Monica Cleary, O.D.
• Haley Clifford
• Douglas Clinton
• Hye Jung Clossey, LICSW

• 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 Jul 8, 2007; 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.