MR. DEREK CLARK BOCO C.PED
NPI 1497161590
Orthotist in Albuquerque, NM

Active since July 09, 2014
5111 JUAN TABO BLVD NE, STE A, ALBUQUERQUE, NM 87111(505) 200-9004(505) 271-0217 Get Directions Write a Review

NPPES record last updated: July 9, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Derek Clark Boco C.ped NPPES

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

MR. DEREK CLARK BOCO C.PED (NPI 1497161590) is an individual orthotist provider in Albuquerque, New Mexico, licensed in Maryland (C49914) and active in the NPI registry since July 2014.

NPPES Registry Identity

NPI1497161590
Entity TypeIndividualMale
Primary Taxonomy222Z00000X
Provider Legal NameMR. DEREK CLARKCredential: BOCO C.PED
Location Address5111 JUAN TABO BLVD NE, STE AAlbuquerque, NM 87111
Mailing Address5111 Juan Tabo Blvd Ne, Ste AAlbuquerque, NM 87111 · (505) 200-9004 · Fax (505) 271-0217
Fax(505) 271-0217
Sole ProprietorNo
Enumeration DateJuly 9, 2014
NPI 1497161590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthotistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code222Z00000X
License Licensed in MD · C49914
Definition

A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.

5111 JUAN TABO BLVD NE, Albuquerque, NM 87111

Other Providers at the Same Location NPPES 9

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

Podiatrist (Foot & Ankle Surgery)
5111 JUAN TABO BLVD NE
ALBUQUERQUE, NM 87111
Podiatrist (Foot & Ankle Surgery)
5111 JUAN TABO BLVD NE
ALBUQUERQUE, NM 87111
Podiatrist
5111 JUAN TABO BLVD NE
ALBUQUERQUE, NM 87111
Podiatrist (Foot & Ankle Surgery)
5111 JUAN TABO BLVD NE
ALBUQUERQUE, NM 87111
Podiatrist (Foot & Ankle Surgery)
5111 JUAN TABO BLVD NE
ALBUQUERQUE, NM 87111
Podiatrist
5111 JUAN TABO BLVD NE
ALBUQUERQUE, NM 87111
Podiatrist (Foot & Ankle Surgery)
5111 JUAN TABO BLVD NE
ALBUQUERQUE, NM 87111
Podiatrist
5111 JUAN TABO BLVD NE
ALBUQUERQUE, NM 87111

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 Derek Clark's NPI number?

The NPI number for Derek Clark is 1497161590. It was assigned to this individual provider in the NPPES registry on July 9, 2014.

Where is Derek Clark located?

Derek Clark practices at 5111 Juan Tabo Blvd NE Ste A, Albuquerque, NM 87111. The listed phone number is (505) 200-9004.

What is Derek Clark's specialty?

The primary specialty registered for this NPI is Orthotist with taxonomy code 222Z00000X.

When was this NPI record last updated?

The NPPES record for Derek Clark was last updated on July 9, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.