Kendall R. Clark, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

200200101 Issued in NC

Practice address

119 SW Maynard Rd Ste 150
Cary, NC 27511-4472

Phone

(919) 578-8593

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

Yes

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 OH, WI2 enrollments

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 2

Specialty

Family PracticeAlso: Peripheral Vascular Disease

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aspirus Riverview Hospital and Clinics IncGroup PAC ID 4587658182, 166 clinicians

Emergency Professional Services, Inc.Group PAC ID 7214832435, 121 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aspirus Riverview Hospital & Clinics Inc Hospital, Wisconsin Rapids, WI, CCN 520033
• Adams County Regional Medical Center Hospital, Seaman, OH, CCN 361326

Merit-based Incentive Payment System (MIPS)

Final score

90.65 of 100Reported as group

Quality

87.9

Promoting interoperability

100

Improvement activities

40

Cost

73.87

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Aspirus Riverview Hospital & Clinics, Inc.

  dba Aspirus Outpatient Therapies - Wisconsin Rapids

  • General Acute Care Hospital
  • Wisconsin Rapids, WI
  • NPI 1295754844

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• Emergency Professional Services, Inc.

  dba Emergency Professional Services of Ohio, Inc.

  • Emergency Medicine Physician
  • Seaman, OH
  • NPI 1093762353
  Medicare reassignment Care Compare group NPD
• Ohio Emergency Professionals Inc

  • Emergency Medicine Physician
  • Columbus, OH
  • NPI 1982983425
  Medicare reassignment
• Aspirus Medical Group, Inc.

  dba Aspirus Podiatry Associates

  • Podiatric Clinic/Center
  • Wausau, WI
  • NPI 1689976474
  NPD
• Aspirus Riverview Hospital & Clinics, Inc.

  dba Aspirus Clinic - Marshfield

  • Rural Health Clinic/Center
  • Marshfield, WI
  • NPI 1124633870
  NPD
• Aspirus Wausau Hospital, Inc.

  dba Aspirus Wausau Hospital Kidney Care

  • Nephrology Physician
  • Wausau, WI
  • NPI 1629179908
  NPD (past)

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

• Adams County Regional Medical Center

  • Critical Access Hospital
  • Seaman, OH
  • NPI 1851946909
  Care Compare affiliation
• Aspirus Riverview Hospital & Clinics, Inc.

  dba Aspirus Clinic - Marshfield

  • Rural Health Clinic/Center
  • Marshfield, WI
  • NPI 1124633870

  Hospital

  Care Compare affiliation
• Aspirus Riverview Hospital & Clinics, Inc.

  dba Aspirus Outpatient Therapies - Wisconsin Rapids

  • General Acute Care Hospital
  • Wisconsin Rapids, WI
  • NPI 1295754844
  Care Compare affiliation

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1568509685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 SW MAYNARD RD STE 150",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114472",
            "telephone_number": "919-578-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 SW MAYNARD RD STE 150",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114472",
            "telephone_number": "919-578-8593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 SW 160th Ave",
            "address_2": "SUITE 250",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330276308",
            "country_code": "US",
            "telephone_number": "877-866-7123",
            "fax_number": "855-855-2792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 S Bennett St",
            "address_purpose": "LOCATION",
            "city": "Southern Pines",
            "state": "NC",
            "postal_code": "283875402",
            "country_code": "US",
            "telephone_number": "910-695-1313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KENDALL",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.144519",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME65017",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200200101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denny Clark
• Devante Montrez Clark
• Dominick Clark
• Ebonee Monique Clark, LCMHCA
• Kalaysha Clark
• Kimberly Renee Clark, SLP
• Maliyah D Clark
• McKenna Clark
• Natalie Clark
• Nyhjah Clark

• Family Medicine Physician in Cary, NC
• Providers in Cary, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.