Individual provider Active NPI

Valerie Marie Clark, WHNP-BC

  • Women's Health Nurse Practitioner
  • Paducah, KY
National Provider Identifier
1679941579
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
3008469 Issued in KY
Practice address
2605 Kentucky Ave
Suite 304
Paducah, KY 42003-3800
Phone
(270) 575-4555
Fax
(270) 575-4882
NPI assigned
Sep 9, 2015
Sex
Female
Sole proprietor
Yes

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
Women's Health Nurse Practitioner 363LW0102X 3008469 KY Primary

Addresses

Primary practice location

2605 Kentucky Ave
Suite 304
Paducah, KY 42003-3800

Mailing address

2605 Kentucky Ave
Suite 306
Paducah, KY 42003-3800
Phone (270) 415-7653

Other identifiers 1

IdentifierTypeStateIssuer
7100381560MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vclark28385@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
I20151120000246 KY Practitioner - Nurse Practitioner 7517267768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2605 Kentucky Ave
Suite 304
Paducah, KY 42003-3802
Phone (270) 575-4555

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

State licenses

LicenseStateTypeSpecialty
3008469KYMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Dec 1, 2015 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Dec 1, 2015 Accepting new patients
Baptist Health Medical Group Inc Past Accepting new patients

Locations

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

2605 Kentucky Ave
Ste 103
Paducah, KY 42003
Phone (270) 442-9461

2605 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 575-4555

2605 Kentucky Ave
Ste 306
Paducah, KY 42003
Phone (270) 415-7653

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 1

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": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1679941579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 KENTUCKY AVE",
            "address_2": "SUITE 306",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033800",
            "telephone_number": "270-415-7653",
            "fax_number": "270-575-8359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 KENTUCKY AVE",
            "address_2": "SUITE 304",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033800",
            "telephone_number": "270-575-4555",
            "fax_number": "270-575-4882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "VALERIE",
        "middle_name": "MARIE",
        "credential": "WHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-09",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "KY",
            "license": "3008469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100381560",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vclark28385@bhkydirect.com",
            "affiliation": "N",
            "address_1": "2605 Kentucky Ave",
            "address_2": "SUITE 304",
            "city": "Paducah",
            "state": "KY",
            "country_code": "US",
            "postal_code": "420033800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.