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DR. JOHN CHARLES CLARK M.D.
NPI 1174664890
Radiology - Therapeutic Radiology in Redding, CA

Active since February 08, 2007PECOS Enrolled
1325 BAMBURY CT, REDDING, CA 96001(530) 246-4971(530) 241-6847 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. John Charles Clark M.d. NPPES

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

DR. JOHN CHARLES CLARK M.D. (NPI 1174664890) is an individual therapeutic radiology provider in Redding, California, licensed in California (A24026) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174664890
Entity TypeIndividualMale
Primary Taxonomy2085R0203X
Provider Legal NameDR. JOHN CHARLES CLARKCredential: M.D.
Location Address1325 BAMBURY CTRedding, CA 96001-1339
Mailing Address1325 Bambury CtRedding, CA 96001-1339 · (530) 246-4971 · Fax (530) 241-6847
Phone(530) 246-4971
Fax(530) 241-6847
Sole ProprietorYes
Enumeration DateFebruary 8, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1174664890 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Therapeutic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0203X
License✔ Licensed in CA · A24026
Definition
Therapeutic Radiology certificate name was changed to Radiation Oncology. Use Radiation Oncology.
1325 BAMBURY CT, Redding, CA 96001
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Other Identifiers 1

Medicare UPINA23792CA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. John Charles 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 John Clark's NPI number?

The NPI number for John Clark is 1174664890. It was assigned to this individual provider in the NPPES registry on February 8, 2007.

Where is John Clark located?

John Clark practices at 1325 Bambury Ct, Redding, CA 96001. The listed phone number is (530) 246-4971.

What is John Clark's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Therapeutic Radiology, with taxonomy code 2085R0203X.

Is John Clark enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for John Clark was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.