Katlyn Reine McClure, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-826 Issued in AR

Practice address

9601 Baptist Health Dr Ste 860
Little Rock, AR 72205-6375

Phone

(501) 975-7455

Fax

(501) 975-3631

NPI assigned

Feb 27, 2019

Sex

Female

Sole proprietor

No

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 KS

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Dermatology and Skin Cancer Specialists, LLC

  • Dermatology Physician
  • Leawood, KS
  • NPI 1205880846
  Medicare reassignment
• Dermatology and Skin Cancer Specialists, LLC.

  • Dermatology Physician
  • Lees Summit, MO
  • NPI 1366632697
  NPD
• Skin & Mohs Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Leawood, KS
  • NPI 1669577524
  NPD
• Skin & Mohs Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Lees Summit, MO
  • NPI 1881875227
  NPD

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1568929487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4261 STOCKTON DRIVE SUITE LL100",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "72117",
            "telephone_number": "501-975-7456",
            "fax_number": "501-978-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 BAPTIST HEALTH DR STE 860",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056375",
            "telephone_number": "501-975-7455",
            "fax_number": "501-975-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "KATLYN",
        "middle_name": "REINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey L.M. McClellan, MD
• Mya McClellan, RN
• Dana S McClendon, M.S.,R.D.,C.S.O.
• Suzanne Roberson McClendon, M.A, CCC-SLP
• McClure & Associates, LLC
• Timothy Patrick McClure, M.D.
• Carol McCluskey, SLP
• Edgar Bornman McColgan, PH.D.
• Neesa J McCollum Flaxman, M.D.
• Tyreesha McCollum

• Physician Assistant in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.