Individual provider Active NPI

Davis Whitney Clark Jr., DO

  • Emergency Medicine Physician
  • West Chester, PA
National Provider Identifier
1992741318
Registry record updated Sep 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
237051 Issued in NY
Practice address
701 E Marshall St
West Chester, PA 19380-4412
Phone
(610) 431-5150
NPI assigned
Jun 22, 2006
Last updated
Sep 7, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 237051 NY Primary

Addresses

Primary practice location

701 E Marshall St
West Chester, PA 19380-4412

Mailing address

PO Box 425
Lederach, PA 19450-0425
Phone (800) 528-0006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090618000270 PA Practitioner - Emergency Medicine 1658305594 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Philadelphia College of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Care Specialists PCGroup PAC ID 4082517479, 17 clinicians

Practice addresses (Care Compare)

701 E Marshall St
West Chester, PA 19380-4412
Phone (800) 528-0006

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
237051NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Care Specialists, PC Emergency Medicine CurrentSince Jul 1, 2009 Accepting new patients
Einstein Practice Plan, Inc CurrentSince Jul 1, 2009 Accepting new patients
Einstein Practice Plan Inc CurrentSince Jul 1, 2009 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
Emergency Medicine Associates P.a., P.C. Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Cortland County, PLLC Emergency Medicine Past Accepting new patients
Emergency Medicine Associates Emergency Medicine Past Accepting new patients

Locations

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

701 E Marshall St
West Chester, PA 19380
Phone (610) 431-5000

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1992741318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 425",
            "city": "LEDERACH",
            "state": "PA",
            "postal_code": "194500425",
            "telephone_number": "800-528-0006",
            "fax_number": "732-349-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E MARSHALL ST",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193804412",
            "telephone_number": "610-431-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DAVIS",
        "middle_name": "WHITNEY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "237051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.