NPIMap

Individual provider Active NPI

Kimberly Clark, M.D./PH.D.

  • Emergency Medicine Physician
  • Raeford, NC
National Provider Identifier
1386879062
Registry record updated Jul 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2013-00534 Issued in NC
Practice address
210 Medical Pavilion Dr
Raeford, NC 28376-9111
Phone
(910) 904-8000
NPI assigned
May 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2013-00534 NC Primary

Addresses

Primary practice location

210 Medical Pavilion Dr
Raeford, NC 28376-9111

Mailing address

26 Oxton Cir
Pinehurst, NC 28374-8880
Phone (404) 824-1518

Other practice location 1

2817 Rock Merritt Ave
Fort Bragg, NC 28310-0001
Phone (910) 907-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20130814001037 NC Practitioner - Emergency Medicine 1850533266 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Human Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hoke Emergency Group, PCGroup PAC ID 7214200146, 44 clinicians

Practice addresses (Care Compare)

210 Medical Pavilion Dr
Raeford, NC 28376-9111
Phone (910) 904-8000

Hospital & facility affiliations

  • Cape Fear Valley Hoke Hospital Hospital, Raeford, NC, CCN 340188
  • Cape Fear Valley Medical Center Hospital, Fayetteville, NC, CCN 340028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013-00534NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sandhills Emergency Physicians PA CurrentSince Jul 1, 2013 Accepting new patients
Hoke Emergency Group, PC Emergency Medicine CurrentSince Jun 18, 2023 Accepting new patients

Locations

155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000

210 Medical Pavilion Dr
Raeford, NC 28376
Phone (910) 904-8000

Interoperability endpoints

  • Direct secure messaging: kclark116389@capefearvalley.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1243123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785024000000",
    "number": "1386879062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 OXTON CIR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748880",
            "telephone_number": "404-824-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MEDICAL PAVILION DR",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283769111",
            "telephone_number": "910-904-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2817 Rock Merritt Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Bragg",
            "state": "NC",
            "postal_code": "283100001",
            "country_code": "US",
            "telephone_number": "910-907-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "M.D./PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-24",
        "last_updated": "2026-07-26",
        "certification_date": "2026-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2013-00534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raeford, NC

Sources for this page

Verify at the official NPI Registry.