Evan Leigh Clark, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3009995 Issued in KY

Practice address

546 Lone Oak Rd
Paducah, KY 42003-4526

Phone

(270) 441-4850

NPI assigned

Jan 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

James N Eickholz MD PSCGroup PAC ID 1951601129, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Paducah Hospital, Paducah, KY, CCN 180104
• Mercy Health - Lourdes Hospital Hospital, Paducah, KY, CCN 180102

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eclark485560@direct.bsmhealth.org
• Direct secure messaging: evan.clark.1@28719.direct.athenahealth.com

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.

• James N Eickholz MD PSC

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1487687133
  Medicare reassignment Care Compare group NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441

  KY

  Medicare reassignment NPD

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

• Baptist Healthcare System, Inc

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1730264128
  Care Compare affiliation
• Mercy Health-Lourdes Hospital LLC

  • Clinical Medical Laboratory
  • Paducah, KY
  • NPI 1245620640

  Hospital

  Care Compare affiliation
• Mercy Health-Lourdes Hospital LLC

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1346244126
  Care Compare affiliation

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

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1083071443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 KENNETH LN",
            "city": "HICKORY",
            "state": "KY",
            "postal_code": "420519558",
            "telephone_number": "270-705-4684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 LONE OAK RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420034526",
            "telephone_number": "270-441-4850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 Kentucky Ave",
            "address_purpose": "LOCATION",
            "city": "Paducah",
            "state": "KY",
            "postal_code": "420033813",
            "country_code": "US",
            "telephone_number": "270-575-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "EVAN",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-15",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3009995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter R Ciampa, D.M.D.
• Ciaras Caring LLC
• Circle of Light Consulting, LLC
• Clark Elementary School Clinic
• Allison Clark
• Katie Clark
• Marty Clark, APRN
• Samuel Kent Clark, D.C.
• Shelby Lynn Clark
• Valerie Marie Clark, WHNP-BC

• Family Nurse Practitioner in Paducah, KY
• Providers in Paducah, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.