Kevin R Ward, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

APRN-NP147488 Issued in GA

Practice address

Clark-Holder Clinic, P.a.
303 Smith Street
Lagrange, GA 30240

Phone

(706) 882-8831

Fax

(706) 812-4091

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Nurse Practitioner

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kward57242@direct.emory.org

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.

• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168
  Medicare reassignment Care Compare group NPD
• Urology Associates of East Alabama LLC

  dba Urology Associates of East Alabama

  • Urology Physician
  • Opelika, AL
  • NPI 1831717867
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1629014907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CLARK-HOLDER CLINIC, P.A.",
            "address_2": "303 SMITH STREET",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "30240",
            "telephone_number": "706-882-8831",
            "fax_number": "706-812-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CLARK-HOLDER CLINIC, P.A.",
            "address_2": "303 SMITH STREET",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "30240",
            "telephone_number": "706-882-8831",
            "fax_number": "706-812-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "KEVIN",
        "middle_name": "R",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "APRN-NP147488",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN147488",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891002400",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000908696A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East, LP. (Walmart pharmacy 10-3164)
• Walgreen Co (Rite Aid #11769)
• Walgreen Co (Walgreens #09622)
• Lisa N. Wallace, LPTA
• Amanda Howington Ward, PHYSICIAN ASSISTANT
• Alfred Antonio Ware, NEMT
• Amy Melissa Ware, PP
• Laqua'Sha Monique Warren, MSN, APRN, FNP-C
• John Paul Warrick Jr., DPM
• Ryer Bionca Warrior, BSN, RN

• Adult Health Nurse Practitioner in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.