What is Gregory Clark, O.D., Inc.'s NPI number?

Gregory Clark, O.D., Inc.'s National Provider Identifier (NPI) is 1801965504, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.

What type of organization is Gregory Clark, O.D., Inc.?

Gregory Clark, O.D., Inc. is classified in the NPPES registry as Optometrist (Eye and Vision Services Providers).

Where is Gregory Clark, O.D., Inc. located?

Gregory Clark, O.D., Inc.'s practice location on file with NPPES is 12547 Riverdale Blvd Nw, Coon Rapids, MN 55448-6708.

What is Gregory Clark, O.D., Inc.'s phone number?

The practice phone number listed in the NPPES registry for Gregory Clark, O.D., Inc. is (763) 712-7761.

Does Gregory Clark, O.D., Inc. accept Medicare?

Gregory Clark, O.D., Inc. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.

Who is the authorized official for Gregory Clark, O.D., Inc.?

The authorized official listed on Gregory Clark, O.D., Inc.'s NPPES record is Gregory Clark, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.

Is Gregory Clark, O.D., Inc.'s NPI active?

Yes — Gregory Clark, O.D., Inc.'s NPI (1801965504) is active in the NPPES registry as of the last update on 2012-11-29.

OrganizationActiveAccepts Medicare

Gregory Clark, O.D., Inc.

NPI 1801965504 · Optometrist · Coon Rapids, MN

Gregory Clark, O.D., Inc. is a Optometrist organization in Coon Rapids, MN (NPI 1801965504).

Provider details

NPI number: 1801965504
Entity type: Organization
Primary specialty: OptometristEye and Vision Services Providers
Organization subpart: No
Authorized official: Gregory Clark, Owner(612) 703-0298
License: 2806 (MN)

Practice location

12547 Riverdale Blvd Nw

Costco Optical Department

Coon Rapids, MN 55448-6708

Phone: (763) 712-7761

Fax: (763) 712-7787

Street-level locationGet directions

More MN providers

Mailing address

16160 22nd Pl N

Plymouth, MN 55447-2382

Specialties & taxonomies

OptometristPrimary152W00000XLicense 2806 (MN)
Eye and Vision Services Providers

Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)

Profile Score

Detailed profile(91/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
20 yrs in NPPES registry
Profile completeness38% of score
100% of core fields populated
Practice footprint23% of score
1 documented practice location

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Enumerated: 2006-11-07
Last updated: 2012-11-29

Frequently asked questions

What is Gregory Clark, O.D., Inc.'s NPI number?: Gregory Clark, O.D., Inc.'s National Provider Identifier (NPI) is 1801965504, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
What type of organization is Gregory Clark, O.D., Inc.?: Gregory Clark, O.D., Inc. is classified in the NPPES registry as Optometrist (Eye and Vision Services Providers).
Where is Gregory Clark, O.D., Inc. located?: Gregory Clark, O.D., Inc.'s practice location on file with NPPES is 12547 Riverdale Blvd Nw, Coon Rapids, MN 55448-6708.
What is Gregory Clark, O.D., Inc.'s phone number?: The practice phone number listed in the NPPES registry for Gregory Clark, O.D., Inc. is (763) 712-7761.
Does Gregory Clark, O.D., Inc. accept Medicare?: Gregory Clark, O.D., Inc. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
Who is the authorized official for Gregory Clark, O.D., Inc.?: The authorized official listed on Gregory Clark, O.D., Inc.'s NPPES record is Gregory Clark, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
Is Gregory Clark, O.D., Inc.'s NPI active?: Yes — Gregory Clark, O.D., Inc.'s NPI (1801965504) is active in the NPPES registry as of the last update on 2012-11-29.

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Provider details

Practice location

Mailing address

Specialties & taxonomies

Profile Score

Registry dates

Frequently asked questions

Specialties & taxonomies

Profile Score

Frequently asked questions