DR. JANICE PATRECE CLARK DPM NPI 1811168339

NPI Information

NPI: 1811168339
Provider Name: DR. JANICE PATRECE CLARK, DPM
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

PECOS Registration: Yes

Address:
1660 S COLUMBIAN WAY
SEATTLE, WA
ZIP 98108
Phone: (206) 716-5651
Get Directions

DR. Janice Patrece Clark, DPM is a foot and ankle surgery podiatrist in Seattle, WA with 19 years of experience. DR. Janice Patrece Clark, DPM NPI is 1811168339. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1660 S COLUMBIAN WAY
SEATTLE, WA
ZIP 98108-532
Phone: (206) 716-5651

The NPI 1811168339 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).

The enumeration date for this NPI number is 3/13/2008 and was last updated on 7/21/2022.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207XX0004X	Orthopaedic Surgery	Foot and Ankle Surgery	POD001114	GEORGIA	No
2	213ES0103X	Podiatrist	Foot & Ankle Surgery	CL011	NEW MEXICO	No
3	213ES0103X	Podiatrist	Foot & Ankle Surgery	0689	ARIZONA	No
4	213ES0103X	Podiatrist	Foot & Ankle Surgery	R57676	NEW YORK	No
5	213ES0103X	Podiatrist	Foot & Ankle Surgery	POD001114	GEORGIA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	294861171A	MEDICAID	GEORGIA
2	2009-10-01	OTHER	GEORGIA	PSHP
3	PAR-2009-07-20	OTHER	GEORGIA	GREAT WEST
4	2009-08-01	OTHER	GEORGIA	UNITED HEALTHCARE
5	GPD114	MEDICAID	SOUTH CAROLINA
6	PAR-2009-08-28	OTHER	GEORGIA	TRICARE
7	PAR	OTHER	GEORGIA	AETNA
8	1289105	OTHER	GEORGIA	AMERIGROUP
9	519981	OTHER	GEORGIA	WELLCARE
10	52246038-001	OTHER	GEORGIA	BCBSGA
11	2009-07-20	OTHER	GEORGIA	CIGNA
12	20091544	OTHER	GEORGIA	SELECT HEALTH

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: 4/28/2024

NPI Synchronization or Removal

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