Individual provider Active NPI

Katherine Clark, AGNP-C

  • Adult Health Nurse Practitioner
  • Whitsett, NC
National Provider Identifier
1043678170
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5008338 Issued in NC
Practice address
940 Golf House CT E
Whitsett, NC 27377-9296
Phone
(336) 449-9838
NPI assigned
Feb 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 234589 NC
Adult Health Nurse Practitioner 363LA2200X 5008338 NC Primary

Addresses

Primary practice location

940 Golf House CT E
Whitsett, NC 27377-9296

Mailing address

2004 Otter Creek Dr
Whitsett, NC 27377-9322
Phone (918) 691-1134

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kclark8627@direct.conehealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160309001602 NC Practitioner - Nurse Practitioner 4880990373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moses Cone Medical Services IncGroup PAC ID 2769395458, 214 clinicians

Practice addresses (Care Compare)

940 Golf House CT E
Whitsett, NC 27377-9296
Phone (336) 449-9848

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5008338NCMDAdult Health Nurse Practitioner
234589NCMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Medical Services, Inc. CurrentSince Feb 21, 2016 Accepting new patients
Moses Cone Medical Services, Inc. CurrentSince Feb 21, 2016 Accepting new patients

Locations

1126 N Church St
Ste 300
Greensboro, NC 27401
Phone (336) 547-1700

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

940 Golf House Ct E
Whitsett, NC 27377
Phone (336) 449-9848

Organizations & group practices 2

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 2

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": "1454457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1043678170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 OTTER CREEK DR",
            "city": "WHITSETT",
            "state": "NC",
            "postal_code": "273779322",
            "telephone_number": "918-691-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 GOLF HOUSE CT E",
            "city": "WHITSETT",
            "state": "NC",
            "postal_code": "273779296",
            "telephone_number": "336-449-9838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATHERINE",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-03",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "234589",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5008338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kclark8627@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "940 Golf House Ct E",
            "city": "Whitsett",
            "state": "NC",
            "country_code": "US",
            "postal_code": "273779296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Whitsett, NC

Sources for this page

Verify at the official NPI Registry.