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DR. KIRBY DWIGHT CLARK M.D. NPI 1447288311


NPI Information

NPI: 1447288311
Provider Name: DR. KIRBY DWIGHT CLARK, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Organization: FAIRVIEW CLINICS

PECOS Registration: Yes

Address:
UFP PHALEN VILLAGE CLINIC
1414 MARYLAND AVENUE EAST
SAINT PAUL, MN
ZIP 55106
Phone: (651) 772-3461
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DR. Kirby Dwight Clark, M.D. is a family medicine in Saint Paul, MN with 23 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Kirby Dwight Clark, M.D. NPI is 1447288311. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduation Year:2001

The provider's business location address is:

UFP PHALEN VILLAGE CLINIC
1414 MARYLAND AVENUE EAST
SAINT PAUL, MN
ZIP 55106
Phone: (651) 772-3461
Fax: (651) 772-2605

The NPI 1447288311 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • Hemoglobin A1C level (HCPCS:83036)

The enumeration date for this NPI number is 6/29/2006 and was last updated on 7/9/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine45690MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1A024OTHERMINNESOTACHAMPUS
234411800MEDICARE ID-TYPE UNSPECIFIEDWISCONSINWI MA
3HP54853OTHERMINNESOTAHEALTHPARTNERS
4H92410MEDICARE UPINMINNESOTA
5080012679MEDICARE ID-TYPE UNSPECIFIEDMINNESOTAMN MEDICARE
6135432OTHERMINNESOTAUCARE
7676T8CLOTHERMINNESOTABCBS
8128460600MEDICAIDMINNESOTA
901-21349OTHERMINNESOTAMEDICA CHOICE & PRIMARY
102374581OTHERMINNESOTAARAZ
11P00055775MEDICARE ID-TYPE UNSPECIFIEDMINNESOTARAIL ROAD MEDICARE
120567727MEDICAIDIOWA
131044612OTHERMINNESOTAPREFERRED ONE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.