Kim P Lark DO PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A110698 Issued in NM

Legal business name

KIM P LARK DO PC

Practice address

2402 W Pierce St
Ste 4a
Carlsbad, NM 88220-3537

Phone

(505) 234-9964

Fax

(505) 234-9962

NPI assigned

Sep 27, 2007

Last updated

Nov 12, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Christi Michelle Yerby

Title

Billing Specialist

Phone

(505) 234-9964

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kim P Lark, D.O.

  • Family Medicine Physician
  • Carlsbad, NM
  • NPI 1023009016
  Medicare reassignment NPD

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194825600000",
    "number": "1720275357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 W PIERCE ST",
            "address_2": "STE 4A",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203537",
            "telephone_number": "505-234-9964",
            "fax_number": "505-234-9962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 W PIERCE ST",
            "address_2": "STE 4A",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203537",
            "telephone_number": "505-234-9964",
            "fax_number": "505-234-9962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM P LARK DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2007-11-12",
        "status": "A",
        "authorized_official_last_name": "YERBY",
        "authorized_official_first_name": "CHRISTI",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "505-234-9964",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "A110698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00T9592",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NM004378",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Helene Lynne Kehrman, PT
• Ginger Kessler
• Vishal Kholwadwala, PHARMD
• Kids' Safehouse of Eddy County
• Kids' Safehouse of Eddy County
• Lyndsay King, H.I.S.
• Daniel Kirkes
• Marti Francess Kirkes, LMSW
• Suzanne Marie Kiser, RN, BSN
• Hajara Namiiro Kizito

• Family Medicine Physician in Carlsbad, NM
• Providers in Carlsbad, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.