Individual provider Active NPI

Lindsey Grace Clark, PA

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1013775543
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3518 Issued in KY
Practice address
1000 S Limestone
Lexington, KY 40536-4033
Phone
(859) 323-9057
Fax
(859) 323-9502
NPI assigned
Mar 11, 2024
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA3518 KY
Surgical Physician Assistant 363AS0400X PA3518 KY
Physician Assistant 363A00000X PA3518 KY Primary

Addresses

Primary practice location

1000 S Limestone
Lexington, KY 40536-4033

Mailing address

489 Woodland Pass
Mount Washington, KY 40047-5822
Phone (423) 435-1380

Other practice location 1

215 5th St
Marietta, OH 45750-4033
Phone (800) 331-7896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241016002169 KY Practitioner - Physician Assistant 6507398450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of KentuckyGroup PAC ID 3072425289, 778 clinicians

Practice addresses (Care Compare)

101 Sanders-Brown BLDG
Lexington, KY 40536-0001
Phone (859) 257-1412

740 S Limestone
E214
Lexington, KY 40536-0001
Phone (859) 323-3368

770 Rose St
Mn328
Lexington, KY 40536-0001
Phone (859) 323-8873

800 Rose St
Lexington, KY 40536-0001
Phone (859) 257-8562

800 Rose St
Lexington, KY 40536-7001
Phone (859) 257-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA3518KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Sep 25, 2024 Accepting new patients

Locations

1000 S Limestone
Lexington, KY 40506
Phone (859) 323-5901

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1013775543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 WOODLAND PASS",
            "city": "MOUNT WASHINGTON",
            "state": "KY",
            "postal_code": "400475822",
            "telephone_number": "423-435-1380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S LIMESTONE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405364033",
            "telephone_number": "859-323-9057",
            "fax_number": "859-323-9502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 5th St",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "OH",
            "postal_code": "457504033",
            "country_code": "US",
            "telephone_number": "800-331-7896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LINDSEY",
        "middle_name": "GRACE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-11",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA3518",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "PA3518",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA3518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.