Katherine Sue Clark, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

501887 Issued in NC

Practice address

7700 US Highway 158
Stokesdale, NC 27357-9346

Phone

(800) 226-8874

NPI assigned

Jun 28, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, GA, FL3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

QSM-Ga, IncGroup PAC ID 3779842729, 12 clinicians

QSM-FL, IncGroup PAC ID 0648548982, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations (25 of 28)

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• QSM-Ga, Inc

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356852123

  Family

  Medicare reassignment Care Compare group NPD
• QSM-FL, Inc

  • Surgery Physician
  • Hollywood, FL
  • NPI 1609318617
  Medicare reassignment Care Compare group
• QSM-NC, PA

  • Surgery Physician
  • Durham, NC
  • NPI 1881136893

  Family

  Medicare reassignment NPD
• Quality Surgical Management Inc

  • Surgery Physician
  • Hollywood, FL
  • NPI 1376758904
  Medicare reassignment NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)
• QSM-Ky, Inc

  • General Practice Physician
  • Hollywood, FL
  • NPI 1114539202

  Family

  NPD (past)

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1376220798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3791 S CRANBERRY BLVD",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342864310",
            "telephone_number": "941-266-3681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 US HIGHWAY 158",
            "city": "STOKESDALE",
            "state": "NC",
            "postal_code": "273579346",
            "telephone_number": "800-226-8874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 S Ocean Dr Ste 209",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330192915",
            "country_code": "US",
            "telephone_number": "305-466-9988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATHERINE",
        "middle_name": "SUE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11023419",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "GAA-NP001335",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "501887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana Baynes
• Helina Chan, MA CCC/SLP
• Chandler Quintessence Combs, PHARMD, RPH
• Compass Healthcare and Rehab Guilford, LLC
• Countryside Manor, Inc
• Morgan Kelley Cribb, OTR/L
• Cronin Chiropractic and Acupuncture Clinic

• Family Nurse Practitioner in Stokesdale, NC
• Providers in Stokesdale, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.