Brent A Clark (NPI# 1407820418, PAC ID# 5890757363) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PODIATRY.
| Nation Provider ID (NPI) | 1407820418 |
| PAC ID by PECOS | 5890757363 |
| Professional Enrollment ID | I20100714000463 |
| Full Name | Brent A Clark |
| Organization Legal Name | INLAND NORTHWEST SURGERY CENTER PLLC |
| Address |
526 N Mullan Rd Suite B Spokane Valley WA 99206-2407 |
| Phone Number | 5099242600 |
| Gender | M |
| Credential | DPM |
| Medical School | CALIFORNIA COLLEGE PODIATRIC MEDICINE |
| Graduation Year | 1999 |
| Primary Specialty | PODIATRY |
| Group Practice PAC ID | 0648169094 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 501310 | NEWPORT COMMUNITY HOSPITAL |
| 500119 | MULTICARE VALLEY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 427 N 12th St, Plummer, ID 83851-0388 | 2086861931 | BENEWAH MEDICAL CENTER |
| 526 N Mullan Rd, Suite B, Spokane Valley, WA 99206-2407 | 5099242600 | INLAND NORTHWEST SURGERY CENTER PLLC |
| 229 S 7th St, St Maries, ID 83861-1803 | 5099242600 | INLAND NORTHWEST SURGERY CENTER PLLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_047_overall | Care Plan | 41% | |
| MIPS_EC_047_overall | Care Plan | 41% | |
| MIPS_EC_126_overall | Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation | 100% | |
| MIPS_EC_126_overall | Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation | 100% |
| Organization Legal Name | INLAND NORTHWEST SURGERY CENTER PLLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thomasin K Hammer | Podiatry | Inland Northwest Surgery Center Pllc | 526 N Mullan Rd, Suite B, Spokane Valley, WA 99206-2407 |
| Street Address |
526 N MULLAN RD SUITE B |
| City | SPOKANE VALLEY |
| State | WA |
| Zip | 99206-2407 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thomasin K Hammer | Podiatry | Inland Northwest Surgery Center Pllc | 526 N Mullan Rd, Suite B, Spokane Valley, WA 99206-2407 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer Lyn Nava | Nurse Practitioner | Inpatient Consultants of California Inc | 10410 E 9th Ave, Spokane Valley, WA 99206-3510 |
| Erik Ri Kelly | Nurse Practitioner | Family Medical Care Pllc | 10618 E Sprague Ave, Spokane Valley, WA 99206-3634 |
| Susan A Schippman | Nurse Practitioner | 9803 E Sprague Ave, Spokane Valley, WA 99206-3645 | |
| Jacqueline Babol | Podiatry | 9405 E Sprague Ave, Spokane, WA 99206-3694 | |
| Emilie Lehman | Physical Therapy | Gordon Physical Therapy Pllc | 626 N Mullan Rd, Suite 4, Spokane Valley, WA 99206-3857 |
| Rebecca L Pagotelis | Physical Therapy | Gordon Physical Therapy Pllc | 626 N Mullan Rd, Suite 4, Spokane Valley, WA 99206-3857 |
| Sandra Kay Nolting | Physical Therapy | Gordon Physical Therapy Pllc | 626 N Mullan Rd, Suite 4, Spokane Valley, WA 99206-3857 |
| Tara M Greene | Physical Therapy | Gordon Physical Therapy Pllc | 626 N Mullan Rd, Suite 4, Spokane Valley, WA 99206-3857 |
| Luke S Gordon | Physical Therapy | Gordon Physical Therapy Pllc | 626 N Mullan Rd, Suite 4, Spokane Valley, WA 99206-3857 |
| Kristin L Ramsay | Physical Therapy | Gordon Physical Therapy Pllc | 626 N Mullan Rd, Suite 4, Spokane Valley, WA 99206-3857 |
| Find all physicians in zip 99206 | |||
| City | SPOKANE VALLEY |
| Zip Code | 99206 |
| Specialty | PODIATRY |
| City + Specialty | SPOKANE VALLEY + PODIATRY |
Please comment or provide details below to improve the information on Brent A Clark.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.