NPIMap

Individual provider Active NPI

Kevin R Clark, DO

  • General Practice Physician
  • Hickory, NC
National Provider Identifier
1053373399
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
200300020 Issued in NC
Practice address
420 N Center St
Hickory, NC 28601-5046
Phone
(843) 237-3378
Fax
(843) 237-5073
NPI assigned
Apr 3, 2006
Last updated
Jun 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 200300020 NC Primary
Emergency Medicine Physician 207P00000X 200300020 NC

Addresses

Primary practice location

420 N Center St
Hickory, NC 28601-5046

Mailing address

PO Box 60359
Charlotte, NC 28260-0359
Phone (843) 237-3378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050131000236 NC Practitioner - General PracticePractitioner - Emergency Medicine 5799735445 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Emergency Medicine
Education
Philadelphia College of Osteopathic Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Eldercare PAGroup PAC ID 0648184705, 236 clinicians
Curana Health of North Carolina PLLCGroup PAC ID 1850774332, 274 clinicians
Geriatric Consultants PLLCGroup PAC ID 5294132387, 56 clinicians

Practice addresses (Care Compare)

5306 NC Hwy 55
Suite 105
Durham, NC 27713-7812
Phone (337) 991-9276

581 NC Hwy 16 S
Taylorsville, NC 28681-9103
Phone (860) 882-7525

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
200300020NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Eldercare PA General Practice CurrentSince Aug 15, 2025 Accepting new patients
Careconnectmd North Carolina P.C. General Practice CurrentSince Nov 2, 2023 Accepting new patients
Curana Health of North Carolina PLLC CurrentSince Nov 10, 2025 Accepting new patients
Lake Norman Emergency Medical Associates LLC Emergency Medicine Past Accepting new patients
Greens at Viewmont LLC Past Accepting new patients
Universal Health Care / Lenoir, Inc Past Accepting new patients
Southern Chester County Emergency Room Associates PC Emergency Medicine Past Accepting new patients
Greens at Lincolnton LLC Past Accepting new patients
Lincolnton Rehabilitation Center, LLC Past Accepting new patients
Liberty Healthcare Group, LLC Past Accepting new patients
Frye Emergency Medical Associates LLC Emergency Medicine Past Accepting new patients
Accordius Health at Wilkesboro LLC Past Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

5306 NC Highway 55
Ste 105
Durham, NC 27713
Phone (919) 457-1517

555 S Mangum St
Ste 100
Durham, NC 27701
Phone (323) 545-3659

707 N Elm St
High Point, NC 27262
Phone (336) 885-0141

4692 Brownsboro Rd
Winston Salem, NC 27106
Phone (336) 251-1114

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lenoir Health and Rehabilitation CenterLenoir, NC, CCN 345138 Skilled nursing facility Adp of the SNF Dec 12, 2025
White Oak Manor - ShelbyShelby, NC, CCN 345171 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2024
Jan 29, 2026
Hibriten Mountain Nursing and RehabilitationLenoir, NC, CCN 345329 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2025
May 1, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1053373399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60359",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600359",
            "telephone_number": "843-237-3378",
            "fax_number": "843-237-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N CENTER ST",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286015046",
            "telephone_number": "843-237-3378",
            "fax_number": "843-237-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KEVIN",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "200300020",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "200300020",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.