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Gregory Clark, O.D., Inc.

Optometrist in Coon Rapids, MN · enumerated 2006 · authorized official Gregory Clark, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1801965504

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Registry record

Entity type Organization (Type 2)
Legal business name Gregory Clark, O.D., Inc.
Practice address 12547 Riverdale Blvd Nw, Costco Optical Department, Coon Rapids, MN, 55448
Phone (763) 712-7761
Fax (763) 712-7787
Enumeration date Nov 7, 2006
Last updated in NPPES Nov 29, 2012

Taxonomy & classification

152W00000X Optometrist Eye and Vision Services Providers · License 2806 (MN) Primary

Authorized official

Name Gregory Clark
Title Owner
Phone (612) 703-0298

Other identifiers

Identifier Type State Issuer
1634747-00 Medicaid MN -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Gregory Clark, O.D., Inc.?
The NPI for Gregory Clark, O.D., Inc. is 1801965504, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Gregory Clark, O.D., Inc.?
NPPES lists Gregory Clark (Owner) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2012-11-29.