1. Home
  2. Directory
  3. Missouri
  4. Springfield
  5. Family Medicine
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

JONATHAN CLARK
NPI 1164415204
Family Medicine in Springfield, MO

Active since August 24, 2005PECOS EnrolledCLIA 26D0903484 · Waiver
1200 E WOODHURST DR, SUITE Q-200, SPRINGFIELD, MO 65804(417) 881-5639(417) 881-5664 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jonathan Clark NPPES

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

JONATHAN CLARK (NPI 1164415204) is an individual family medicine provider in Springfield, Missouri, licensed in Missouri (MD101561) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through July 23, 2027, and is affiliated with Cox Medical Centers.

NPPES Registry Identity

NPI1164415204
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJONATHAN CLARK
Location Address1200 E WOODHURST DR, SUITE Q-200Springfield, MO 65804-4257
Mailing Address1200 E Woodhurst Dr, Suite Q-200Springfield, MO 65804-4257
Phone(417) 881-5639
Fax(417) 881-5664
Sole ProprietorNo
Medical School CMSUniversity Of Missouri, Columbia School Of MedicineGraduated 1992
Enumeration DateAugust 24, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1164415204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MO · MD101561
Definition

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.

1200 E WOODHURST DR, Springfield, MO 65804
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID1456412667
PECOS Enrollment IDI20220727003379
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D0903484

Jonathan L Clark MD · Springfield, MO
Active · expires Jul 23, 2027
CLIA Number26D0903484
Laboratory TypePhysician Office
Certificate Effective DateJuly 24, 2025
Certificate Expiration DateJuly 23, 2027
Laboratory DirectorJonathan L. Clark MD
Laboratory Phone(417) 881-5639
Laboratory LocationJonathan L Clark MD1200 E Woodhurst, Ste Q200, Springfield, MO 65804
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
29 services20 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
22 services19 patients
Telephone medical discussion with physician, 11-20 minutes 99442
This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
13 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Cox Medical Centers

Acute Care Hospitals · Springfield, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260040
Location3801 South National AvenueSpringfield, MO 65807 · Greene County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65804 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$93.24 typical visit price
range $16.30 – $131.05
Typical copayment $23.31 (range $4.07 – $32.76)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANDREW ALLEN JOHNS DDS
Dentist
1200 E WOODHURST DR, STE H-200
SPRINGFIELD, MO 65804
Greene County (417) 881-6000
ASCEND DENTAL DESIGN, LLC
Clinic/Center (Dental)
1200 E WOODHURST DR, BUILDING U
SPRINGFIELD, MO 65804
Greene County (417) 887-3100
WELLNESS CONCEPTS CLINIC
Chiropractor
1200 E WOODHURST DR, SUITE R300
SPRINGFIELD, MO 65804
Greene County (417) 877-1300
CANDACE WAWRA
Hearing Instrument Specialist
1200 E WOODHURST DR, SUITE Q BUILDING 100
SPRINGFIELD, MO 65804
Greene County (417) 881-1010
SPRINGFIELD HEARING CENTER
Clinic/Center (Hearing and Speech)
1200 E WOODHURST DR, BUILDING Q, SUITE 100
SPRINGFIELD, MO 65804
Greene County (417) 881-1010
THERAPY ASSOCIATES OF THE OZARKS, INC.
Speech-Language Pathologist
1200 E WOODHURST DR, STE. M300
SPRINGFIELD, MO 65804
Greene County (417) 882-7284
DR. REBECCA E CHRESTMAN DOM & LAC
Acupuncturist
1200 E WOODHURST DR, R300
SPRINGFIELD, MO 65804
Greene County (417) 877-1300
WELLNESS CONCEPTS CLINIC LLC
Chiropractor (Sports Physician)
1200 E WOODHURST DR, STE R 300
SPRINGFIELD, MO 65804
Greene County (417) 877-1300

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 Jonathan Clark's NPI number?

The NPI number for Jonathan Clark is 1164415204. It was assigned to this individual provider in the NPPES registry on August 24, 2005.

Where is Jonathan Clark located?

Jonathan Clark practices at 1200 E Woodhurst Dr Suite Q-200, Springfield, MO 65804. The listed phone number is (417) 881-5639.

What is Jonathan Clark's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jonathan Clark enrolled in Medicare?

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

Does Jonathan Clark hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0903484) is associated with this NPI, valid through July 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Jonathan Clark affiliated with any hospitals?

According to CMS data, Jonathan Clark is affiliated with Cox Medical Centers.

When was this NPI record last updated?

The NPPES record for Jonathan Clark was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.