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TIMOTHY CLARK M.D.
NPI 1083096341
Student in an Organized Health Care Education/Training Program in Minneapolis, MN

Active since June 23, 2015PECOS Enrolled
521 S 7TH ST, APT 502, MINNEAPOLIS, MN 55415(613) 501-3552 Get Directions Write a Review

NPPES record last updated: June 23, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Timothy Clark M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIMOTHY CLARK M.D. (NPI 1083096341) is an individual student in an organized health care education/training program in Minneapolis, Minnesota and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083096341
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameTIMOTHY CLARKCredential: M.D.
Location Address521 S 7TH ST, APT 502Minneapolis, MN 55415-1620
Mailing Address521 S 7th St, Apt 502Minneapolis, MN 55415-1620
Phone(613) 501-3552
Sole ProprietorNo
Enumeration DateJune 23, 2015
✔ NPI 1083096341 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

521 S 7TH ST, Minneapolis, MN 55415
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Timothy Clark M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Timothy Clark's NPI number?

The NPI number for Timothy Clark is 1083096341. It was assigned to this individual provider in the NPPES registry on June 23, 2015.

Where is Timothy Clark located?

Timothy Clark practices at 521 S 7th St Apt 502, Minneapolis, MN 55415. The listed phone number is (613) 501-3552.

What is Timothy Clark's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Timothy Clark enrolled in Medicare?

Yes. Timothy Clark is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Timothy Clark was last updated on June 23, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.