Kristen Ann Clark, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

15 Hospital Center Blvd Ste 1
Hilton Head Island, SC 29926-2760

Phone

(843) 689-9200

Fax

(843) 689-9200

NPI assigned

Jun 7, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kristen Ann Zioncheck Former name

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Waccamaw Dermatology LLCGroup PAC ID 7315021169, 26 clinicians

Oandw EnterprisesGroup PAC ID 6608927298, 216 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.01 of 100Reported as group

Quality

100

Improvement activities

40

Cost

66.69

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kaclark@directaddress.net
• Direct secure messaging: kclark@waccamawdermatology.emadirect.md

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.

• Waccamaw Dermatology, LLC

  • Dermatology Physician
  • Myrtle Beach, SC
  • NPI 1962449181
  Medicare reassignment Care Compare group
• O&W Enterprises

  • Physical Therapist
  • Stanleytown, VA
  • NPI 1487895348
  Care Compare group
• Coastal Kidney Center PA

  • Nephrology Physician
  • Conway, SC
  • NPI 1801961537
  NPD (past)

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1245769850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 HOSPITAL CENTER BLVD STE 1",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299262760",
            "telephone_number": "843-689-9200",
            "fax_number": "843-689-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 HOSPITAL CENTER BLVD STE 1",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299262760",
            "telephone_number": "843-689-9200",
            "fax_number": "843-689-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KRISTEN",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC LICENSE",
            "identifier": "MPA2748",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "ZIONCHECK",
            "middle_name": "ANN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chirowellness, Inc.
• Marietta M. Chua, M.D.
• Lisette Cifaldi, LISW-CP
• Clare J Charles Lisw-CP LLC
• Ella Karen Clark, PA
• Matthew Michael Clark, PT
• Kristofer Clarke
• Nicole Lee Clegg, APRN, FNP-C
• Clemson Sports Medicine and Rehabilitation (Clemson PT & Spine Rehab)
• Clemson Sports Medicine and Rehabilitation Inc (Island Physical Therapy)

• Physician Assistant in Hilton Head Island, SC
• Providers in Hilton Head Island, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.