Individual provider Active NPI

Kiley Faye Clark, MD

  • Emergency Medicine Physician
  • Bakersfield, CA
National Provider Identifier
1114676913
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A197675 Issued in CA
Practice address
1700 Mount Vernon Ave
Bakersfield, CA 93306-4018
Phone
(661) 326-2168
Fax
(661) 326-2165
NPI assigned
Mar 21, 2022
Last updated
Feb 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A197675 CA Primary

Addresses

Primary practice location

1700 Mount Vernon Ave
Bakersfield, CA 93306-4018

Mailing address

1700 Mount Vernon Ave
Bakersfield, CA 93306-4018
Phone (661) 326-2168

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260223000064 CA Practitioner - Emergency Medicine 7810478419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2100 Powell St
Suite 400
Emeryville, CA 94608-1872

5820 Owens Dr BLDG E 2ND Floor
Pleasanton, CA 94588-3900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A197675CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California Emergency Medicine CurrentSince Feb 1, 2026 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Feb 1, 2026 Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

Organizations & group practices 3

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 5

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": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1114676913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 MOUNT VERNON AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933064018",
            "telephone_number": "661-326-2168",
            "fax_number": "661-326-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 MOUNT VERNON AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933064018",
            "telephone_number": "661-326-2168",
            "fax_number": "661-326-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KILEY",
        "middle_name": "FAYE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A197675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.