NPIMap

Individual provider Active NPI

Casey Lane Clark

  • Internal Medicine Physician
  • Winchester, KY
National Provider Identifier
1306340286
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
56386 Issued in KY
Practice address
1850 Bypass Rd
Winchester, KY 40391-2300
Phone
(859) 744-5111
Fax
(859) 744-1177
NPI assigned
Mar 23, 2018
Last updated
Aug 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 56386 KY Primary
Pediatrics Physician 208000000X 56386 KY

Addresses

Primary practice location

1850 Bypass Rd
Winchester, KY 40391-2300

Mailing address

PO Box 936
London, KY 40743-0936
Phone (859) 744-5111

Other practice location 1

900 S Limestone Ctw 304
Lexington, KY 40536-0001
Phone (859) 323-6561

Other identifiers 1

IdentifierTypeStateIssuer
7100615740MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20220902002251 KY Practitioner - Internal MedicinePractitioner - Pediatric Medicine 5193052447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Kentucky College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1850 Bypass Rd
Winchester, KY 40391-2300
Phone (859) 744-5111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kentuckyone Health Medical Group, Inc. Internal Medicine CurrentSince Oct 1, 2022 Accepting new patients

Locations

305 Estill St
Berea, KY 40403
Phone (859) 986-1415

1401 Harrodsburg Rd
Ste A300
Lexington, KY 40504
Phone (859) 313-4744

1850 Bypass Rd
Winchester, KY 40391
Phone (859) 744-5111

Interoperability endpoints

  • Direct secure messaging: cclark17089@ukhcdirect.org
  • Direct secure messaging: cclark303245@direct.stlukeshealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1306340286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430936",
            "telephone_number": "859-744-5111",
            "fax_number": "859-744-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 BYPASS RD",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403912300",
            "telephone_number": "859-744-5111",
            "fax_number": "859-744-1177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 S Limestone Ctw 304",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360001",
            "country_code": "US",
            "telephone_number": "859-323-6561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CASEY",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-23",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "56386",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "56386",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100615740",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, KY

Sources for this page

Verify at the official NPI Registry.