Individual provider Active NPI

Ian Clark, PA

  • Physician Assistant
  • Owensboro, KY
National Provider Identifier
1033960968
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3443 Issued in KY
Practice address
2200 E Parrish Ave Ste 101C
Owensboro, KY 42303-1450
Phone
(270) 688-1650
Fax
(270) 688-1651
NPI assigned
Mar 28, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA3443 KY Primary

Addresses

Primary practice location

2200 E Parrish Ave Ste 101C
Owensboro, KY 42303-1450

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330

Other practice location 1

510 Ruby Dr
Madisonville, KY 42431-2168
Phone (270) 399-7900

Other practice location 2

1301 Pleasant Valley Rd Ste 201
Owensboro, KY 42303-9774
Phone (270) 417-7510

Other practice location 3

1200 Barret Blvd
Henderson, KY 42420-4950
Phone (270) 844-8600

Other practice location 4

811 E Parrish Ave Ste 102-B
Owensboro, KY 42303-3258
Phone (270) 688-1009

Other practice location 5

2025 W Everly Brothers Blvd Ste 1A
Powderly, KY 42367-5401
Phone (270) 377-2600

Other practice location 6

2211 Mayfair Dr Ste 101
Owensboro, KY 42301-4569
Phone (270) 688-1352

Electronic endpoints 6

TypeEndpointUseAffiliation
Direct Messaging Address iclark126802@direct.owensborohealth.org
Direct Messaging Address iclark126802@direct.owensborohealth.org
Direct Messaging Address iclark126802@direct.owensborohealth.org
Direct Messaging Address iclark126802@direct.owensborohealth.org
Direct Messaging Address iclark126802@direct.owensborohealth.org
Direct Messaging Address iclark126802@direct.owensborohealth.org

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
I20240803000163 KY Practitioner - Physician Assistant 4385181726 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
Owensboro Health Medical Group IncGroup PAC ID 0648255034, 455 clinicians

Practice addresses (Care Compare)

1201 Pleasant Valley Rd
Owensboro, KY 42303-9811

1301 Pleasant Valley Rd
Owensboro, KY 42303-9774

2200 E Parrish Ave
Suite 101C
Owensboro, KY 42303-1450
Phone (270) 688-1650

2211 Mayfair Dr
Owensboro, KY 42301-4569

PO Box
Suite 23229
Owensboro, KY 42304-3229

Hospital & facility affiliations

  • Owensboro Health Regional Hospital Hospital, Owensboro, KY, CCN 180038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TP168KYMDHospitalist Physician
PA3443KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group, Inc CurrentSince Jun 17, 2024 Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Jun 17, 2024 Accepting new patients
Owensboro Health Medical Group, Inc Physician Assistant Past Accepting new patients

Locations

1200 Barret Blvd
Henderson, KY 42420
Phone (270) 844-8600

510 Ruby Dr
Madisonville, KY 42431
Phone (270) 399-7757

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

811 E Parrish Ave
#102B
Owensboro, KY 42303
Phone (270) 688-1009

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

1301 Pleasant Valley Rd
Ste 201
Owensboro, KY 42303
Phone (270) 417-7500

2200 E Parrish Ave
Ste 101C
Owensboro, KY 42303
Phone (270) 683-3073

2025 W Everly Brothers Blvd
Ste 1
Powderly, KY 42367

2025 W Everly Brothers Blvd
Ste 1A
Powderly, KY 42367
Phone (270) 377-2600

Organizations & group practices 4

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

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": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1033960968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E PARRISH AVE STE 101C",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031450",
            "telephone_number": "270-688-1650",
            "fax_number": "270-688-1651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Ruby Dr",
            "address_purpose": "LOCATION",
            "city": "Madisonville",
            "state": "KY",
            "postal_code": "424312168",
            "country_code": "US",
            "telephone_number": "270-399-7900",
            "fax_number": "270-399-7910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1301 Pleasant Valley Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423039774",
            "country_code": "US",
            "telephone_number": "270-417-7510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Barret Blvd",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "KY",
            "postal_code": "424204950",
            "country_code": "US",
            "telephone_number": "270-844-8600",
            "fax_number": "270-844-8610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "811 E Parrish Ave Ste 102-B",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423033258",
            "country_code": "US",
            "telephone_number": "270-688-1009",
            "fax_number": "270-688-1010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2025 W Everly Brothers Blvd Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Powderly",
            "state": "KY",
            "postal_code": "423675401",
            "country_code": "US",
            "telephone_number": "270-377-2600",
            "fax_number": "270-377-2610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2211 Mayfair Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423014569",
            "country_code": "US",
            "telephone_number": "270-688-1352",
            "fax_number": "270-683-4313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "IAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-28",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA3443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iclark126802@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "1200 Barret Blvd",
            "city": "Henderson",
            "state": "KY",
            "country_code": "US",
            "postal_code": "424204950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iclark126802@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "811 E Parrish Ave Ste 102-B",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423033258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iclark126802@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "2211 Mayfair Dr Ste 101",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423014569",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iclark126802@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "2200 E Parrish Ave Ste 101C",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423031450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iclark126802@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "2025 W Everly Brothers Blvd Ste 1A",
            "city": "Powderly",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423675401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iclark126802@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "510 Ruby Dr",
            "city": "Madisonville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "424312168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.