DR. KIM M CLARK O.D.
NPI 1215091095
Optometrist in Portland, OR
NPI Status: Active since December 19, 2006
Contact Information
12000 SE 82ND AVENUE
#2012
PORTLAND, OR
ZIP 97266
Phone: (503) 652-6001
Fax: (503) 652-6012
- Individual
- Male
- Optometrist
About KIM CLARK
This page provides the complete NPI Profile along with additional information for Kim Clark, a provider established in Portland, Oregon with a medical specialization in Optometrist. The healthcare provider is registered in the NPI registry with number 1215091095 assigned on December 2006. The practitioner's primary taxonomy code is 152W00000X with license number 2911ATI (OR). The provider is registered as an individual and his NPI record was last updated 17 years ago.
- NPI
- 1215091095
- Provider Name
- DR. KIM M CLARK O.D.
- Other Name
- KIM M CLARK OD
- Other Name Type
- Professional Name (2)
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 12000 SE 82ND AVENUE #2012 PORTLAND, OR 97266
- Location Phone
- (503) 652-6001
- Location Fax
- (503) 652-6012
- Mailing Address
- 2318 NW EDGEWOOD PL PORTLAND, OR 97229
- Mailing Phone
- (503) 292-4033
- Mailing Fax
- (503) 652-6012
- Is Sole Proprietor?
- No
- Enumeration Date
- 12-19-2006
- Last Update Date
- 05-11-2009
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Optometrist
- Taxonomy Code
- 152W00000X
- Type
- Eye and Vision Services Providers
- License No.
- 2911ATI
- License State
- OR
- Taxonomy Description
- Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 000009413 | MEDICARE ID-TYPE UNSPECIFIED (04) | UT |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1215091095, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 55 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1215091095, enumerated as an "individual" on December 19, 2006.
The provider is located at 12000 SE 82ND AVENUE #2012 PORTLAND, OR 97266 and the phone number is (503) 652-6001.
Optometrist with taxonomy code 152W00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
