Kindra Clark, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP126695 Issued in TX

Practice address

5414 Fredericksburg Rd Ste 100a
San Antonio, TX 78229-3641

Phone

(210) 468-0800

Fax

(210) 733-8649

NPI assigned

Oct 17, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kindra.clark.1@18380.direct.athenahealth.com

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.

• Diabetes and Glandular Disease Clinic PA

  • Endocrinology, Diabetes & Metabolism Physician
  • San Antonio, TX
  • NPI 1427166305
  Medicare reassignment NPD
• Vpa of Texas PLLC

  • Family Medicine Physician
  • Irving, TX
  • NPI 1679510499
  Medicare reassignment NPD
• Vpa of Texas PLLC

  • Clinical Social Worker
  • San Antonio, TX
  • NPI 1578175865
  NPD
• St. David'S Carenow Urgent Care PLLC

  • Family Medicine Physician
  • Austin, TX
  • NPI 1851844104
  NPD (past)

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1558765727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 KIRTS BLVD STE 100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844135",
            "telephone_number": "248-824-6623",
            "fax_number": "855-618-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5414 FREDERICKSBURG RD STE 100A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293641",
            "telephone_number": "210-468-0800",
            "fax_number": "210-733-8649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 Dallas St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782051202",
            "country_code": "US",
            "telephone_number": "210-224-1771",
            "fax_number": "210-229-9138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KINDRA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP126695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Clark, R.PH.
• Jessica Lee Clark, RN
• John Woodrow Clark, PTA
• Karla Clark
• Kevin Michael Clark, DDS
• Kristi Gayle Clark, M.D.
• Latisha Clark, MS, ATC, LAT
• Lauren Clark, FNP
• Levon Clark Sr., PA
• Lorraine Beth Clark, LCSW

• Family Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.