Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Jack O. Clark, MD

Individual provider Internal Medicine Physician · NPI 1902992837

Jack O. Clark, MD practises Internal Medicine in Rexburg, Idaho. Graduated from Pennsylvania State University College of Medicine in 1999, 27 years ago. Practices with Madison Co Memorial Hospital, a 34-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
27
Trained at
Pennsylvania State University College of Medicine
Licensed in
ID
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

450 E Main St
Rexburg, ID 83440
Phone: (208) 359-6419
Fax: (208) 356-3111
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 166 S 5th St, Montpelier, ID 83254-1557 — (208) 847-1110

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence M-7743 (ID)

Record details

NPI number1902992837
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 5, 2006
Last updated in NPPESApril 13, 2020
Certification dateApril 13, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolPENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated 1999 (27 years in practice)
Group practice Madison Co Memorial Hospital — 34 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients153
Services billed 289 a service is one billed item, such as a visit, a test or a procedure
Average patient age76

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Madison Co Memorial Hospital

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 34 clinicians in the practice; 12 are shown here.

Other providers in Rexburg