Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Randy R Clark, MD

Individual provider Sports Medicine (Orthopaedic Surgery) Physician · NPI 1679781140

Randy R Clark, MD is an Orthopedic Surgery in St George, Utah. Graduated from University of Utah School of Medicine in 2006, 20 years ago. Practices with Revere Health PC, a 410-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Utah.

Years since qualifying
20
Trained at
University of Utah School of Medicine
Licensed in
UT
In the registry since
2007
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2825 E Mall Dr
St George, UT 84790-1954
Phone: (435) 628-9393
Fax: (435) 628-9382
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Orthopaedic Surgery) Physician (primary) Taxonomy 207XX0005X · Licence 8203740-1205 (UT)
Orthopaedic Surgery Physician Taxonomy 207X00000X · Licence 8203740-1205 (UT)

Record details

NPI number1679781140
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 18, 2007
Last updated in NPPESMarch 20, 2025
Certification dateMarch 20, 2025
Mailing address1055 N 500 W, Attn: Credentialing, Provo, UT 84604-3305

Medicare enrollment

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

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolUNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated 2006 (20 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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