NPIMap

Individual provider Active NPI

Kimberly Anne Clark, PA-C

  • Medical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1144368226
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0002396 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-2882
Fax
(410) 328-2977
NPI assigned
Feb 2, 2007
Last updated
Aug 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0002396 MD Primary
Surgical Physician Assistant 363AS0400X 009342-1 NY

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

4811 Chevy Chase Dr
Chevy Chase, MD 20815-6409
Phone (202) 782-9806

Other practice location 1

827 Linden Ave
Baltimore, MD 21201-4606
Phone (410) 225-8790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20150528000840 MD Practitioner - Physician Assistant 8426129032 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mdics at Anne Arundel LLCGroup PAC ID 1456515519, 32 clinicians

Practice addresses (Care Compare)

2001 Medical Pkwy
Annapolis, MD 21401-3773
Phone (443) 481-1000

22 S Green St
Baltimore, MD 21201-1544

22 S Greene Stre
Med Ctr GCRC Office
Baltimore, MD 21201-1544
Phone (410) 328-7877

2200 Kernan Dr
Baltimore, MD 21207-6665
Phone (410) 448-6383

904 Commerce Rd
Annapolis, MD 21401-2948
Phone (410) 849-6140

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0002396MDMDMedical Physician Assistant
009342-1NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Physicians, P.a. CurrentSince Feb 1, 2025 Accepting new patients
University of Maryland Neurology Associates, P.a. CurrentSince Jun 1, 2017 Accepting new patients
University of Maryland Physicians P.a. CurrentSince Feb 1, 2025 Accepting new patients
University of Maryland Neurology Associates, P.a. CurrentSince Jun 1, 2017 Accepting new patients
One Skincare, LLC Past Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100

Interoperability endpoints

  • Direct secure messaging: kclark504@direct.umm.edu

Organizations & group practices 9

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 3

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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1144368226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4811 CHEVY CHASE DR",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208156409",
            "telephone_number": "202-782-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-2882",
            "fax_number": "410-328-2977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "827 Linden Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212014606",
            "country_code": "US",
            "telephone_number": "410-225-8790",
            "fax_number": "410-225-8910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0002396",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "009342-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.