Clark Anderson, MD
Clark Anderson, MD is a provider specialising in Student in an Organized Health Care Education/Training Program in San Antonio, TX, registered under NPI 1104485770. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 4502 MEDICAL DR, San Antonio, TX 78229. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| NONE | NC | Internal Medicine Physician |
| 0101281056 | VA | Internal Medicine Physician |
Licences are recorded in 2 states: NC, VA. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Radiation Oncology
- PAC ID
- 6608103841
Medicare enrolment is recorded as approved under the provider type Practitioner - Radiation Oncology. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 2 states
This provider holds licences in 2 states: North Carolina and Virginia. Multi-state licensure often means the provider works near a state border, covers more than one office, or delivers care by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Student in an Organized Health Care Education/Training Program covers
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. NUCC Health Care Provider Taxonomy, code 390200000X
All registered taxonomy codes
This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | — | — | primary |
| 207R00000X | Internal Medicine Physician | NONE | NC | |
| 207R00000X | Internal Medicine Physician | 0101281056 | VA |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1104485770 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Jun 7, 2019 |
| Last updated | Jun 25, 2024 |
| Status | Active |
| Sole proprietor | No |
| Credential | MD |
| Practice address |
4502 MEDICAL DR San Antonio, TX 78229 (920) 460-8927 |
| Mailing address |
9666 CRISWELL CRK San Antonio, TX 78251 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 1 | 0 | 4 | 4 | 8 | 5 | 7 | 7 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 1 | 0 | 4 | 8 | 8 | 1 | 7 | 5 |
Sum = 60 · next multiple of 10 = 60 · check digit = 0 · actual last digit = 0
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.