K. Clark Family Medical PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

K. CLARK FAMILY MEDICAL PLLC

Practice address

19938 E Carriage Way
Queen Creek, AZ 85142-4907

Phone

(480) 518-5251

NPI assigned

Jul 18, 2023

Organization subpart

No

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

Authorized official

Name

Kailynn Clark, NPNPI 1205469327

Title

Provider

Phone

(480) 518-5251

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kailynn Andrea Clark, FNP-C

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1205469327
  Medicare reassignment Care Compare group NPD Authorized official
• Nicole Kay Larsen, FNP

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1265918726
  Medicare reassignment Care Compare group NPD
• Melinda Marie Ramsdell, NP

  • Family Nurse Practitioner
  • Apache Junction, AZ
  • NPI 1174995807
  Medicare reassignment Care Compare group NPD
• Krista Cash, MSN, APRN, FNP-C

  • Nurse Practitioner
  • Scottsdale, AZ
  • NPI 1013743293

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715385600000",
    "number": "1700566577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19938 E CARRIAGE WAY",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851424907",
            "telephone_number": "480-518-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19938 E CARRIAGE WAY",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851424907",
            "telephone_number": "480-518-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K. CLARK FAMILY MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2024-05-11",
        "certification_date": "2024-05-11",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "KAILYNN",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "480-518-5251",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desiree Jones
• Lorna Jones, LAC
• Tavyn Jones, SLPA
• Yael Joseph Garcia
• Melissa Justine Perez
• Sarah Nicole Kaesler, B. A.
• Kaizen Psych Professional Limited Liability Company
• Joyce Jane N Karuga
• Katie Plukas PLLC Dba Salt & Light Counseling Services
• Shaye Kawasaki

• Family Nurse Practitioner in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.