DR. HENRY VONDELL CLARK MD
NPI 1790898450
Family Medicine in Tacoma, WA
About Dr. Henry Vondell Clark Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. HENRY VONDELL CLARK MD (NPI 1790898450) is an individual family medicine provider in Tacoma, Washington, licensed in North Carolina (9800216) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Henry Vondell Clark Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Henry Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Asheville, NC 28803
- Reassigned Medicare billing, North Carolina enrollment
- Also billed through NPI 1477609592 (North Carolina)
- 2,998 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 98431 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Reported Quality Measures
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.
TACOMA, WA 98431
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 Henry Clark's NPI number?
The NPI number for Henry Clark is 1790898450. It was assigned to this individual provider in the NPPES registry on August 16, 2006.
Where is Henry Clark located?
Henry Clark practices at 9040 Jackson Ave, Tacoma, WA 98431. The listed phone number is (253) 968-2252.
What is Henry Clark's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Henry Clark enrolled in Medicare?
Yes. Henry Clark is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Henry Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Henry Clark reassigns Medicare benefits to Novant Health Medical Group, LLC (Asheville, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Henry Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Henry Clark was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Dr. Henry Vondell Clark, MD · NPI 1790898450
Family Medicine physician in Tacoma, Washington. Individual provider, active in the CMS NPPES registry since August 16, 2006.
## Identity
- **NPI:** 1790898450 (Entity type: Individual)
- **Enumerated:** August 16, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 9800216 (North Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 9040 JACKSON AVE, Tacoma, WA 98431-9361
- **Phone:** (253) 968-2252
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Novant Health Medical Group, LLC (NPI 1578342861, Asheville, NC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 7, 2023
- **Other identifiers:** Other 11521 (NC); Medicaid 1790898450 (NC); Other 9800216 (NC)
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Source: [NPI Profile](https://npiprofile.com/npi/1790898450) · Data from the CMS NPPES public registry.