Individual provider Active NPI

Christopher A Clark, APRN

  • Family Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1649641895
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3009639 Issued in KY
Practice address
3581 Harrodsburg Rd Ste 350
Lexington, KY 40513-1140
Phone
(859) 313-3400
Fax
(859) 313-3087
NPI assigned
Oct 14, 2015
Last updated
Feb 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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 3009639 KY Primary

Addresses

Primary practice location

3581 Harrodsburg Rd Ste 350
Lexington, KY 40513-1140

Mailing address

PO Box 936
London, KY 40743-0936
Phone (606) 330-7835

Other identifiers 1

IdentifierTypeStateIssuer
7100379660MedicaidKY

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
I20151208001871 KY Practitioner - Nurse Practitioner 3375843758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3581 Harrodsburg Rd
Suite 350
Lexington, KY 40513-1140
Phone (859) 313-3400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3009639KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kentuckyone Health Medical Group, Inc. CurrentSince Nov 2, 2015 Accepting new patients
Neurosurgical Associates PSC Current Accepting new patients
Saint Joseph Medical Foundation, Inc. Past Accepting new patients
Kentuckyone Health Medical Group, Inc. PastSince Nov 2, 2015 Accepting new patients

Locations

305 Estill St
Berea, KY 40403
Phone (859) 986-1415

1099 Duval St
Ste 110
Lexington, KY 40515
Phone (859) 313-3400

1401 Harrodsburg Rd
Ste A300
Lexington, KY 40504
Phone (859) 313-4744

Interoperability endpoints

  • Direct secure messaging: cclark269765@direct.stlukeshealth.org
  • Direct secure messaging: christopherclark@kysjhspe.allscriptsdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1649641895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430936",
            "telephone_number": "606-330-7835",
            "fax_number": "606-330-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3581 HARRODSBURG RD STE 350",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131140",
            "telephone_number": "859-313-3400",
            "fax_number": "859-313-3087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHRISTOPHER",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-14",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3009639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100379660",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.