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Individual provider Active NPI

Karen A Clark, MD

  • Cardiovascular Disease Physician
  • Reno, NV
National Provider Identifier
1174593727
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
21088 Issued in OK
Practice address
3330 Joy Lake Rd
Reno, NV 89511-8789
Phone
(775) 223-1775
NPI assigned
Jan 25, 2006
Last updated
Jun 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 21088 OK
Cardiovascular Disease Physician 207RC0000X 21088 OK Primary

Addresses

Primary practice location

3330 Joy Lake Rd
Reno, NV 89511-8789

Mailing address

3330 Joy Lake Rd
Reno, NV 89511-8789
Phone (775) 223-1775

Other identifiers 1

IdentifierTypeStateIssuer
100102100AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20150224001388 OK Practitioner - Cardiovascular Disease (Cardiology) 6608789474 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Texas Southwestern Medical School at Dallas, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

520 N Monte Vista St C
Mercy Clinic
Ada, OK 74820-4674
Phone (580) 436-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21088OKMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Leflore County Hospital Authority Current Accepting new patients
Mercy Clinic Oklahoma Communities Internal Medicine CurrentSince Dec 1, 2025 Accepting new patients
Leflore County Hospital Authority Cardiovascular Disease CurrentSince Jun 1, 2023 Accepting new patients
Leflore County Hospital Authority CurrentSince Jun 1, 2023 Accepting new patients
Northern Arizona Heart Center Interventional Cardiology Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Hood Medical Group Internal Medicine Past Accepting new patients
New Mexico Heart Institute, LLC Cardiovascular Disease Past Accepting new patients
Karen a Clark MD PA Cardiovascular Disease PastSince Aug 1, 2002 Accepting new patients
Physicians and Allied Health Professionals Group, PA Internal Medicine Past Accepting new patients
Heart Center of Northeastern Arizona, LLC Cardiovascular Disease Past Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients

Locations

520 N Monte Vista St
Ste C
Ada, OK 74820
Phone (580) 272-0018

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

104 Wall St
Poteau, OK 74953
Phone (918) 635-3578

105 Wall St
Poteau, OK 74953
Phone (918) 635-3100

Organizations & group practices 12

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 2

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1174593727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 JOY LAKE RD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895118789",
            "telephone_number": "775-223-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 JOY LAKE RD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895118789",
            "telephone_number": "775-223-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KAREN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "21088",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "21088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100102100A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.