NPI age
19 years
Enumerated 2007-01-09
● Active Type 2 · Organization
Clinton Clark DPM Llc
Clinton Clark DPM Llc is 1 of 67 podiatrist organizations in Idaho.
Primary specialty
Podiatrist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Clark
Owner
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05
How this organization compares
Across 67 active podiatrist providers in Idaho.
NPI age
19 years
↑ 5 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-01Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
6051 N Eagle Rd
Boise, ID 837130997
Mailing address
6051 N Eagle Rd
Boise, ID 837130997
Authorized official
Clinton H Clark, DPM
Owner
📞 2089284670
Individual providers at this organization
6 individual providers on file at this primary practice address.
- Scott Graviet, DPM Podiatrist NPI 1578514618
- Gary Millward, DPM Podiatrist NPI 1063462075
- Dustin Portela, D.O. Dermatology NPI 1588002547
- Jacob Tebbs, PA-C Physician Assistant NPI 1154870251
- Dana Triplitt Denturist NPI 1720920457
- Heidi Van Giffen, L.D. Denturist NPI 1700099694
Specialties
-
Podiatrist PrimaryDefinition to come...
Practice context
Multi-provider organization. 6 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.