Haley Clark
Individual provider Active NPI Physician Assistant · Stanford, KY
NPI 1326417023 · NPPES record last updated Jun 25, 2019
Key facts
- NPI
- 1326417023
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- TC419 (KY)
- Practice address
- 100 Jay St
Stanford, KY 40484-7511 - Phone
- (606) 365-5746
- NPI assigned
- Sep 23, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lexington Urgent Care PLLC
Practice addresses (Care Compare)
1701 Nicholasville Rd
Lexington, KY 40503-1461
Phone (859) 466-8956
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151027001515 | KY | Practitioner - Physician Assistant | 1658680970 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | TC419 | KY | Yes |
Addresses
Primary practice location
100 Jay St
Stanford, KY 40484-7511
Mailing address
436 Logan Creek Dr
Stanford, KY 40484-9524
Phone (859) 324-5746
Other providers in Stanford, KY
- Central Kentucky Diagnostic Center, LLC
- Central Kentucky Family Vision PLLC
- Jeanne A Chase
- Renee Chiu
- Spenser Claiborne
- C. Glen Click
- Shannah Click
- Allison Goble Cocanougher
- Teresa D Coffman
- Colemans Drugstore Inc
All providers in Stanford, KY · Physician Assistant in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.