Carl Wesley Kluck, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

C-5937 Issued in AR

Practice address

2850 Twin Rivers Dr
Arkadelphia, AR 71923-4212

Phone

(870) 246-8036

Fax

(870) 246-7164

NPI assigned

Jan 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HJABAA

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Arkadelphia Clinic for Children and Young Adults, PA

  • Rural Health Clinic/Center
  • Arkadelphia, AR
  • NPI 1467095133

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership
• Arkadelphia Clinic for Children and Young Adults, PA

  • Pediatrics Physician
  • Arkadelphia, AR
  • NPI 1699741033

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership

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.

• Arkadelphia Clinic for Children and Young Adults, PA

  • Rural Health Clinic/Center
  • Arkadelphia, AR
  • NPI 1467095133
  NPD
• Arkadelphia Clinic for Children and Young Adults, PA

  • Pediatrics Physician
  • Arkadelphia, AR
  • NPI 1699741033
  NPD

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1508837485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 TWIN RIVERS DR",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "71923",
            "telephone_number": "870-246-8036",
            "fax_number": "870-246-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 TWIN RIVERS DR",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719234212",
            "telephone_number": "870-246-8036",
            "fax_number": "870-246-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUCK",
        "first_name": "CARL",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "C-5937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105305001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy Kimble, MHPP
• Karri A Kimery, RBT
• Mitzi Jane Kimsey
• Kimberly King
• Kara Breanne Kirksey
• Megan N Knight, PT
• Montana McAdams Knight, PHARMD
• Emmitt Knowles
• Pamelia Lynn Kuyper, BSN
• Joan E Kyle, M.D.

• Pediatrics Physician in Arkadelphia, AR
• Providers in Arkadelphia, AR by specialty
• Pediatrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.