Clark Integrated Medical Clinics LLC
NPI 1124529284ActiveOrganization· General Practice· Lafayette, LA
General Practice in Lafayette, Louisiana, registered in NPPES in February 2018. The authorized official on file is Jacob Scott Clark, DC, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1124529284 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 23, 2018 |
| Last updated in NPPES | Jul 25, 2025 |
| Certified by provider | Jul 25, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
| Chiropractor | 111N00000X | — | — |
| Physician Assistant | 363A00000X | — | — |
| Nurse Practitioner | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (LA) |
|---|
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