EDWIN MERLE CLARK (NPI# 1275578908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275578908 |
| Entity Type | Individual |
| Full Name | EDWIN MERLE CLARK |
| Credential | M.D., F.A.C.S, (QME) |
| Practice Address |
360 E Montvue Dr Suite 100 Meridian ID 83642-6318 |
| Practice Telephone | 2088552900 |
| Practice Fax Number | 2088989877 |
| Mailing Telephone | 2088552900 |
| Mailing Fax Number | 2088989877 |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2008-02-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | M-6683 | ID | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346213626 | Edwin Allen Clark | Podiatrist | 1501 Aldersgate Rd, Little Rock, AR 72205-6611 | 2006-02-08 |
| Street Address |
360 E MONTVUE DR SUITE 100 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-6318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952701401 | Southern Idaho Health Partners LLC | General Practice | 360 E Montvue Dr, Meridian, ID 83642-6318 | 2014-09-02 |
| 1033454426 | Sari Bianca Lavarias | Physician Assistant | 360 E Montvue Dr, Meridian, ID 83642-6318 | 2012-12-11 |
| 1477843811 | Tara Osborne | Physical Therapist | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 | 2011-04-18 |
| 1386887032 | Michael Bryon Spackman | Physical Medicine & Rehabilitation | 360 E Montvue Dr, Suite 100, Meridian, ID 83642 | 2009-04-10 |
| 1770747404 | Christian Vanderford | Physical Therapist | 360 E Montvue Dr, Ste A, Meridian, ID 83642-6318 | 2008-07-11 |
| 1073776258 | Liang Wu | Internal Medicine | 360 E Montvue Dr, Meridian, ID 83642-6318 | 2008-07-08 |
| 1235338682 | Kelli Elizabeth Debooy | Physical Therapist | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 | 2007-07-16 |
| 1689701260 | Shannon L Gardiner | Physician Assistant | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 | 2007-02-28 |
| 1659380269 | Spine Institute of Idaho P A | Orthopaedic Surgery | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 | 2006-08-05 |
| 1962447169 | Samuel Steven Jorgenson | Orthopaedic Surgery | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 | 2006-06-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679909774 | Irvin L. Martin IIi Md Pllc | Orthopaedic Surgery | 1800 12th St Ste 1e, Meridian, MS 39301-4158 | 2013-09-20 |
| 1821006289 | Jared P Tadje | Orthopaedic Surgery | 2365 E Gala St Ste 1, Meridian, ID 83642 | 2006-08-03 |
| 1720027311 | Kyle L Palmer | Orthopaedic Surgery | 3875 East Overland Road, Meridian, ID 83642 | 2006-06-06 |
| 1871589994 | John William Cope | Orthopaedic Surgery | 8310 Eagle Pointe Dr, Meridian, MS 39305-9185 | 2005-09-23 |
| 1730182007 | Harry Durgin | Orthopaedic Surgery | 2024 15th St, Ste 4n, Meridian, MS 39301-4130 | 2005-05-31 |
| 1336747120 | Mikayla Lynn Taugher | Orthopaedic Surgery | 2365 E Gala St Ste 1, Meridian, ID 83642-4881 | 2020-10-13 |
| 1245778208 | Direct Orthopedic Care LLC | Orthopaedic Surgery | 3015 E Magic View Dr, Ste 115, Meridian, ID 83642-3757 | 2017-02-09 |
| 1760840987 | Allied Orthopaedics, LLC | Orthopaedic Surgery | 3015 E Magic View Dr, Suite 120, Meridian, ID 83642-3743 | 2016-02-02 |
| 1356719108 | Tadje Orthopaedics, LLC | Orthopaedic Surgery | 2365 E Gala St Ste 1, Meridian, ID 83642 | 2015-09-10 |
| 1497199020 | Edward Lee Smith | Orthopaedic Surgery | 1800 12th St, Meridian, MS 39301-4158 | 2013-04-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.