Katie Clark, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3740 Issued in MN

Practice address

3408 Bardstown Rd
Louisville, KY 40218-4608

Phone

(502) 912-9884

NPI assigned

Jun 29, 2021

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 MN, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Indiana University - School of Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ky Doctors of Optometry, PLLCGroup PAC ID 0941108732, 64 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ky Doctors of Optometry, PLLC

  • Optometrist
  • Louisville, KY
  • NPI 1700890001
  Medicare reassignment Care Compare group NPD
• Ky Doctors of Optometry, PLLC

  • Eyewear Supplier
  • St Matthews, KY
  • NPI 1801610985

  Optometrist

  NPD
• Tri-State Doctors of

  • Eyewear Supplier
  • Louisville, KY
  • NPI 1275617276

  Optometrist

  NPD

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1164092383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8639 COUNTY ROAD 16 SE",
            "city": "DELANO",
            "state": "MN",
            "postal_code": "553288134",
            "telephone_number": "612-709-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3408 BARDSTOWN RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402184608",
            "telephone_number": "502-912-9884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Marie Clark, LCSW
• Jordan Clark, DMD
• Joseph Clark, LCADC, CSW
• Joshua Clark
• Joshua Scott Clark, MS, OTR/L
• Kellsy Clark
• Kristyn Lyn Clark
• Krystal Clark
• Kylie Clark, DPT
• Latoya Shaneese Clark, PHARMD

• Optometrist in Louisville, KY
• Providers in Louisville, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; 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.