Individual provider Active NPI

Sarah Elizabeth Clark, APRN

  • Family Nurse Practitioner
  • La Grange, KY
National Provider Identifier
1619221884
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3007451 Issued in KY
Practice address
1023 New Moody LN
Suite 102
La Grange, KY 40031
Phone
(502) 222-0598
Fax
(502) 222-7446
NPI assigned
Nov 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3007451 KY Primary

Addresses

Primary practice location

1023 New Moody LN
Suite 102
La Grange, KY 40031

Mailing address

2700 Stanley Gault Pkwy Ste 129
Louisville, KY 40223-5176
Phone (502) 253-4900

Other identifiers 1

IdentifierTypeStateIssuer
7100224760MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sclark6346@bhkydirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20121213000452 KY Practitioner - Nurse Practitioner 8123270444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians
PT Pros, IncGroup PAC ID 0143139337, shared by 14 NPIs, 263 clinicians

Practice addresses (Care Compare)

101 Stonecrest Rd
Shelbyville, KY 40065-8169

1025 New Moody LN
La Grange, KY 40031-9154
Phone (502) 222-3255

3900 Kresge Way
Louisville, KY 40207-4681

4031 N Dixie Hwy
Suite 104
Elizabethtown, KY 42701-7873
Phone (270) 982-4776

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Medical Associates Inc CurrentSince Feb 22, 2016 Accepting new patients
Baptist Health Medical Group Inc Past Accepting new patients

Locations

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

Organizations & group practices 3

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1619221884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 STANLEY GAULT PKWY STE 129",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235176",
            "telephone_number": "502-253-4900",
            "fax_number": "502-489-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 NEW MOODY LN",
            "address_2": "SUITE 102",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "40031",
            "telephone_number": "502-222-0598",
            "fax_number": "502-222-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-09",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100224760",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sclark6346@bhkydirect.com",
            "affiliation": "N",
            "address_1": "1023 New Moody Ln",
            "address_2": "Suite 102",
            "city": "LA Grange",
            "state": "KY",
            "country_code": "US",
            "postal_code": "40031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Grange, KY

Sources for this page

Verify at the official NPI Registry.