DR. CLIFFORD R CLARK (NPI# 1497712434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497712434 |
| Entity Type | Individual |
| Full Name | DR. CLIFFORD R CLARK |
| Credential | M.D. |
| Practice Address |
5920 Mcintyre St Golden CO 80403-7445 |
| Practice Telephone | 3039491250 |
| Mailing Telephone | 3039491250 |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2015-12-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 0048886 | CO | Allopathic & Osteopathic Physicians |
| Y | 207RH0002X |
Internal Medicine Specialization: Hospice and Palliative Medicine |
DR.0048886 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | MEDICARE NUMBER | COA104546 | 01 |
| CO | 91080200 | 05 | |
| NM | 13094 | 05 | |
| NM | FEDERAL TAX ID | 850365127 | 01 |
| NM | STATE MEDICAL LICENSE | 8020 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952868879 | Clifford Lloyd Clark Jr. | Occupational Therapy Assistant | 501 Esseola Drive, Saluda, NC 28773 | 2019-02-27 |
| 1649711615 | Clifford Jovan Clark | Counselor | 44070 W 12 Mile Rd, Suite 200, Novi, MI 48377-2648 | 2017-03-10 |
| 1497872246 | Clifford Lee Clark | Social Worker | 2140 E Ellsworth Rd, Ann Arbor, MI 48108-2552 | 2007-03-26 |
| 1770666729 | Clifford P Clark IIi | Plastic Surgery | 701 W Morse Blvd, Winter Park, FL 32789-3731 | 2006-10-23 |
| 1881612653 | Clifford D Clark | Orthopaedic Surgery | 2500 E Prospect Rd, Fort Collins, CO 80525-9718 | 2006-07-18 |
| Street Address |
5920 MCINTYRE ST |
| City | GOLDEN |
| State | CO |
| Zip Code | 80403-7445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215939541 | Timothy J Rodgers | Internal Medicine | 5920 Mcintyre St, Golden, CO 80403-7445 | 2005-05-31 |
| 1184256489 | Sylvia Knop | Nurse Practitioner | 5920 Mcintyre St, Golden, CO 80403-7445 | 2020-02-05 |
| 1578106696 | Nakia Fields | Nurse Practitioner | 5920 Mcintyre St, Golden, CO 80403-7445 | 2019-10-21 |
| 1598312456 | Joseph N Namongo | Nurse Practitioner | 5920 Mcintyre St, Golden, CO 80403-7445 | 2019-08-24 |
| 1437706769 | Elizabeth Claire Ingram | Nurse Practitioner | 5920 Mcintyre St, Golden, CO 80403-7445 | 2019-08-21 |
| 1699329029 | Amanda Griffith | Nurse Practitioner | 5920 Mcintyre St, Golden, CO 80403-7445 | 2019-07-24 |
| 1033672597 | Krystina Enriquez | Nurse Practitioner | 5920 Mcintyre St, Golden, CO 80403-7445 | 2019-04-11 |
| 1245716075 | Brittany Horrigan | Nurse Practitioner | 5920 Mcintyre St, Golden, CO 80403 | 2018-07-15 |
| 1710463765 | Ciara Falzone | Physician Assistant | 5920 Mcintyre St, Golden, CO 80403 | 2018-07-12 |
| 1982199899 | Elizabeth Mweru Wambugu | Nurse Practitioner | 5920 Mcintyre St, Golden, CO 80403 | 2018-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417229394 | Dami Ann Hughes | Massage Therapist | 19562 W 57th Circle, Golden, CO 80403 | 2012-02-07 |
| 1942446075 | Laura Brett | Speech-Language Pathologist | 16941 W 60th Dr, Arvada, CO 80403 | 2008-12-18 |
| 1952453664 | Jan M. Oxman | Psychologist | 17830 W. 53rd Drive, Golden, CO 80403 | 2007-01-16 |
| 1609935337 | Julie Ann Lindsay | Physical Therapist | 109 Rubey Dr, Suite G-h, Golden, CO 80403 | 2006-12-08 |
| 1285660936 | Theraphysics Partners of Colorado, Inc. | Physical Therapist | 112 N Rubey Dr Unit 135, Golden, CO 80403 | 2006-06-24 |
| 1811930043 | Cynthia K Petrinovic | Occupational Therapist | 3935 Douglas Mtn Drive, Golden, CO 80403 | 2006-06-14 |
| 1114463882 | Summit Speech and Language Therapy, LLC | Speech-Language Pathologist | 16941 W 60th Dr, Arvada, CO 80403 | 2017-01-18 |
| 1891183448 | Tracy Gardner | Speech-Language Pathologist | 5987 Dunraven St, Golden, CO 80403-1007 | 2015-01-06 |
| 1548665110 | Michelle Dawn | Registered Nurse | 5977 Dunraven St, Golden, CO 80403-1007 | 2014-10-25 |
| 1093927352 | Quality Home Living | Contractor | 5900 Blanca Ct, Golden, CO 80403-1023 | 2007-05-07 |
| Find all providers in zip 80403 | ||||
| Taxonomy Code | 207RH0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hospice and Palliative Medicine |
| An internal medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care. |
| Notes: Source: American Academy of Hospice and Palliative Medicine, www.aahpm.org [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457731929 | Catholic Health Initiatives Colorado | Internal Medicine | 9100 E Mineral Cir, 2nd Floor, Centennial, CO 80112-3401 | 2015-05-31 |
| 1962771196 | John T Lynn | Internal Medicine | 5450 Tech Center Dr, 120, Colorado Springs, CO 80919-2339 | 2011-12-16 |
| 1598738114 | John G Massone | Internal Medicine | 2594 Trailridge Dr E, Lafayette, CO 80026-3186 | 2006-02-13 |
| 1477556934 | Tru Community Care | Internal Medicine | 2594 Trailridge Drive East, Lafayette, CO 80026-3187 | 2005-05-27 |
| 1164030862 | Poudre Valley Medical Group, LLC | Internal Medicine | 2121 E Harmony Rd Unit 170, Fort Collins, CO 80528-3413 | 2020-07-20 |
| 1528676228 | Poudre Valley Medical Group, LLC | Internal Medicine | 6767 29th St, Greeley, CO 80634-5474 | 2020-07-20 |
| 1982212684 | Poudre Valley Medical Group, LLC | Internal Medicine | 1500 Park Central Dr Ste 101, Highlands Ranch, CO 80129-6692 | 2020-07-20 |
| 1790393494 | Poudre Valley Medical Group, LLC | Internal Medicine | 2500 Rocky Mountain Ave, Loveland, CO 80538-9004 | 2020-07-20 |
| 1609484302 | Poudre Valley Medical Group, LLC | Internal Medicine | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-07-20 |
| 1033749353 | Taylor Martindell | Internal Medicine | 1400 E Boulder St, Colorado Springs, CO 80909-5533 | 2020-01-26 |
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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.