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DR. GORDON BLAKE CLARK MD
NPI 1417937145
Obstetrics & Gynecology - Obesity Medicine in Shawnee, KS

Active since January 19, 2006PECOS EnrolledAccepts Medicare Assignment
21624 MIDLAND DR, SHAWNEE, KS 66218(913) 643-0075(913) 643-0077 Get Directions Write a Review

NPPES record last updated: November 2, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Gordon Blake Clark Md NPPES

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

DR. GORDON BLAKE CLARK MD (NPI 1417937145) is an individual obesity medicine provider in Shawnee, Kansas, licensed in Kansas (04-23518) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Adventhealth Shawnee Mission, and is a graduate of University Of Kansas School Of Med (kc/wich/sal) (1989).

NPPES Registry Identity

NPI1417937145
Entity TypeIndividualMale
Primary Taxonomy207VB0002X
Provider Legal NameDR. GORDON BLAKE CLARKCredential: MD
Location Address21624 MIDLAND DRShawnee, KS 66218-9064
Mailing Address21624 Midland DrShawnee, KS 66218-9064 · (913) 643-0075 · Fax (913) 643-0077
Phone(913) 643-0075
Fax(913) 643-0077
Sole ProprietorYes
Medical School CMSUniversity Of Kansas School Of Med (kc/wich/sal)Graduated 1989
Enumeration DateJanuary 19, 2006
Last NPPES UpdateNovember 2, 2011
✔ NPI 1417937145 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & Gynecology · Obesity MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207VB0002X
License✔ Licensed in KS · 04-23518
Definition
An obstetrics & gynecology physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the genetic, biologic, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions including diet, physical activity, behavioral change, and pharmacotherapy. The obesity medicine physician utilizes a comprehensive approach, and may include additional resources such as dietitians, exercise physiologists, mental health professionals and bariatric surgeons as indicated to achieve optimal results. Additionally, the obesity medicine physician maintains competency in providing pre- peri- and post-surgical care of bariatric surgery patients, promotes the prevention of obesity, and advocates for those who suffer from obesity.
Also ListedObstetrics & GynecologyTaxonomy 207V00000X · License KS 04-23518 (KS)
21624 MIDLAND DR, Shawnee, KS 66218
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Other Identifiers 3

Medicare UPING25880KS
Medicare ID-Type UnspecifiedP868019KS
Medicaid100305190DKS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Gordon Blake Clark Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7618875378
PECOS Enrollment IDI20111213000326
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.

Areas of Expertise CMS Part B claims

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 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.
137 services31 patients

Hospital Affiliations CMS Care Compare

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

Adventhealth Shawnee Mission

Acute Care Hospitals · Shawnee Mission, KS
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number170104
Location9100 W 74th StreetShawnee Mission, KS 66204 · Johnson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 66218 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
$122.41 typical visit price
range $53.00 – $161.67
Typical copayment $30.60 (range $13.25 – $40.41)
Most-billed visit code 99204
Established Patient
$66.40 typical visit price
range $16.88 – $132.11
Typical copayment $16.60 (range $4.22 – $33.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers18 claims18 services$27.94 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

WOMEN' S AND FAMILY CARE DBA GTC RESEARCH
Clinic/Center (Multi-Specialty)
21624 MIDLAND DR
SHAWNEE, KS 66218
Johnson County (913) 643-0075
COMPREHENSIVE WOMEN'S CARE, INC.
Family Medicine
21624 MIDLAND DR
SHAWNEE, KS 66218
Johnson County (913) 643-0075
TRACY A CLARK ARNP
Nurse Practitioner (Family)
21624 MIDLAND DR
SHAWNEE, KS 66218
Johnson County (913) 643-0075
COMPREHENSIVE WOMEN'S CARE, INC.
Nurse Practitioner (Family)
21624 MIDLAND DR
SHAWNEE, KS 66218
Johnson County (913) 643-0075

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 Gordon Clark's NPI number?

The NPI number for Gordon Clark is 1417937145. It was assigned to this individual provider in the NPPES registry on January 19, 2006.

Where is Gordon Clark located?

Gordon Clark practices at 21624 Midland Dr, Shawnee, KS 66218. The listed phone number is (913) 643-0075.

What is Gordon Clark's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Obesity Medicine, with taxonomy code 207VB0002X.

Is Gordon Clark enrolled in Medicare?

Yes. Gordon Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Gordon Clark accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 2 other insurers list Gordon Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Gordon Clark affiliated with any hospitals?

According to CMS data, Gordon Clark is affiliated with Adventhealth Shawnee Mission.

When was this NPI record last updated?

The NPPES record for Gordon Clark was last updated on November 2, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.