DR. BRENDAN J CLARK (NPI# 1265419659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265419659 |
| Entity Type | Individual |
| Full Name | DR. BRENDAN J CLARK |
| Credential | MD |
| Practice Address |
274 Union Blvd Ste 110 Lakewood CO 80228 |
| Mailing Address |
274 Union Blvd Ste 110 Lakewood CO 80228-1836 |
| Practice Telephone | 3039510600 |
| Mailing Telephone | 3039510600 |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2018-06-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
46478 | CO | Allopathic & Osteopathic Physicians |
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
46478 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 77226267 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497126601 | Brendan Clark | Counselor | 1800 Mercy Dr, Orlando, FL 32808-5646 | 2015-10-14 |
| Street Address |
274 UNION BLVD STE 110 |
| City | LAKEWOOD |
| State | CO |
| Zip Code | 80228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245644376 | Derek Low | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228 | 2014-06-17 |
| 1962745190 | Scott Matson | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228 | 2013-04-06 |
| 1346515574 | Kolene Elaine Bailey | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228-1836 | 2012-03-21 |
| 1295002038 | Hannah Marie Hetzel | Nurse Practitioner | 274 Union Blvd Ste 110, Lakewood, CO 80228 | 2011-11-22 |
| 1790079424 | Bianca Silva Sarmento | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228-1836 | 2011-05-28 |
| 1487944997 | Bridget A Graney | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228-1836 | 2011-04-18 |
| 1871720748 | Nathaniel Reid Little | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228 | 2009-06-17 |
| 1598932873 | Andrew Waas | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228-1836 | 2008-05-14 |
| 1184816159 | Dominic John Titone | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228-1836 | 2007-08-14 |
| 1295930931 | Mary Adel Elmasri | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228-1836 | 2007-06-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174083570 | Lindsey Mae Beverly | Physician Assistant | Medical Plaza 2, 11700 W 2nd Pl, #350, Lakewood, CO 80228 | 2019-03-21 |
| 1881119931 | Cory J Frazier | Nurse Practitioner | 11600 W. 2nd Pl, Lakewood, CO 80228 | 2017-08-10 |
| 1508213885 | Chelsea Tucker | Counselor | 12157 W Cedar Dr Ste 207, Lakewood, CO 80228 | 2016-05-17 |
| 1972963841 | Shastin Gerbracht | Counselor | 12055 W 2nd Pl, Ste 200, Lakewood, CO 80228 | 2016-03-04 |
| 1073983375 | Suzanne Phillips | Behavioral Analyst | 200 Union Blvd. Ste. 200, Lakewood, Co. 80228, Denver, CO 80228 | 2015-09-29 |
| 1700265667 | April Mearsha | Doula | 12977 W Cedar Dr, 2-305, Lakewood, CO 80228 | 2015-05-26 |
| 1306233713 | Caleb Hedberg | Internal Medicine | 165 S Union Blvd Ste 800, Lakewood, CO 80228 | 2015-04-23 |
| 1972996288 | David Lindsey Currie | Counselor | 12055 W 2nd Place, Jefferson Ctr for Mental Health, Lakewood, CO 80228 | 2015-03-11 |
| 1619365533 | Michelle Broberg II | Technician | 12055 West 2nd Plaza, Lakewood, CO 80228 | 2014-12-30 |
| 1750789012 | Kayla Morrison | Social Worker | 12005 W 2nd Place, Lakewood, CO 80228 | 2014-12-18 |
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| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558346965 | Julianna Maria Sutarik | Internal Medicine | 274 Union Blvd, Suite 110, Lakewood, CO 80228-1813 | 2005-12-08 |
| 1154879427 | Franciscan Medical Group | Internal Medicine | 9537 Gravelly Lake Dr Sw, Lakewood, WA 98499-1513 | 2016-09-15 |
| 1245644376 | Derek Low | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228 | 2014-06-17 |
| 1962745190 | Scott Matson | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228 | 2013-04-06 |
| 1346515574 | Kolene Elaine Bailey | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228-1836 | 2012-03-21 |
| 1487944997 | Bridget A Graney | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228-1836 | 2011-04-18 |
| 1902112337 | Alexander Kogan | Internal Medicine | 274 Union Blvd, Suite 110, Lakewood, CO 80228-1813 | 2010-08-23 |
| 1871720748 | Nathaniel Reid Little | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228 | 2009-06-17 |
| 1598932873 | Andrew Waas | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228-1836 | 2008-05-14 |
| 1184816159 | Dominic John Titone | Internal Medicine | 274 Union Blvd Ste 110, Lakewood, CO 80228-1836 | 2007-08-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.