Individual provider Active NPI

Katharine Tyler Clark, MD

  • Emergency Medicine Physician
  • Bethesda, MD
National Provider Identifier
1174093629
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
288942 Issued in MA
Practice address
8901 Wisconsin Ave
Bethesda, MD 20889-2696
Phone
(301) 295-4000
NPI assigned
Nov 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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 288942 MA Primary

Addresses

Primary practice location

8901 Wisconsin Ave
Bethesda, MD 20889-2696

Mailing address

8901 Wisconsin Ave
Bethesda, MD 20889-0006
Phone (301) 295-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address katharine.t.clark.mil@health.mil Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20251024002578 DC Practitioner - Emergency Medicine 8628486768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Johns Hopkins University School of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3104 Kent St
Kensington, MD 20895-3207

4535 Dressier Rd NW
Canton, OH 44718-2545

Hospital & facility affiliations

  • Adventist Healthcare White Oak Medical Center Hospital, Silver Spring, MD, CCN 210016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
288942MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mep Health, LLC Emergency Medicine CurrentSince Oct 1, 2025 Accepting new patients

Locations

9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1174093629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890006",
            "telephone_number": "301-295-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208892696",
            "telephone_number": "301-295-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATHARINE",
        "middle_name": "TYLER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "288942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "katharine.t.clark.mil@health.mil",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8901 Wisconsin Ave",
            "city": "Bethesda",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208890006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.