Active NPI
Haley Clark
- Physician Assistant
- Stanford, KY
National Provider Identifier
1326417023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- TC419
- Practice address
- 100 Jay St
Stanford, KY 40484-7511 - Phone
- (606) 365-5746
- NPI assigned
- Sep 23, 2015
- Last updated
- Jun 25, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | TC419 | KY | Primary |
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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1701 Nicholasville Rd
Lexington, KY 40503-1461
Phone (859) 466-8956
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 6
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.
-
- Urgent Care Clinic/Center
- Lexington, KY
- NPI 1225374887
-
- Rural Health Clinic/Center
- Stanford, KY
- NPI 1598869638
-
- Nurse Practitioner
- Berea, KY
- NPI 1912054792
-
- Urgent Care Clinic/Center
- Georgetown, KY
- NPI 1780838847
-
- Urgent Care Clinic/Center
- Lexington, KY
- NPI 1083101240
-
- Rural Health Clinic/Center
- Waynesburg, KY
- NPI 1669670816
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561420800000",
"number": "1326417023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "436 LOGAN CREEK DR",
"city": "STANFORD",
"state": "KY",
"postal_code": "404849524",
"telephone_number": "859-324-5746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 JAY ST",
"city": "STANFORD",
"state": "KY",
"postal_code": "404847511",
"telephone_number": "606-365-5746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "HALEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-23",
"last_updated": "2019-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "TC419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stanford, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; 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.