NPIMap

Individual provider Active NPI

Tara A Clark, D.O.

  • Family Medicine Physician
  • Blue Springs, MO
National Provider Identifier
1750345245
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2004023907 Issued in MO
Practice address
600 NE Adams Dairy Pkwy
Blue Springs, MO 64014-5493
Phone
(816) 251-6100
Fax
(816) 347-4695
NPI assigned
Apr 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2004023907 MO Primary

Addresses

Primary practice location

600 NE Adams Dairy Pkwy
Blue Springs, MO 64014-5493

Mailing address

600 NE Adams Dairy Pkwy
Blue Springs, MO 64014-5493
Phone (816) 251-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050420000262 MO Practitioner - Family Practice 3375581408 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
R Franklin University of Med & Sci/Chicago Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability KCGroup PAC ID 0143116368, 166 clinicians
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

3011 Baltimore Ave
Kansas City, MO 64108-3403
Phone (816) 751-7832

600 NE Adams Dairy Pkwy
Blue Springs, MO 64014-5493
Phone (816) 251-6100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke's Physician Group Inc Family Medicine CurrentSince Oct 31, 2018 Accepting new patients
Truman Medical Center Incorporated Current Accepting new patients
Truman Medical Center, Incorporated Current Accepting new patients
Truman Medical Center, Incorporated CurrentSince Jul 1, 2014 Accepting new patients
Truman Medical Center, Incorporated Family Medicine CurrentSince Jul 1, 2014 Accepting new patients
Robine Medical Associates of Kansas City, Inc. Family Medicine Past Accepting new patients

Locations

2301 Holmes St
Kansas City, MO 64108

7900 Lees Summit Rd
Kansas City, MO 64139
Phone (816) 373-4485

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Interoperability endpoints

  • Direct secure messaging: tclark96509@direct.saint-lukes.org

Organizations & group practices 7

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 10

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1750345245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 NE ADAMS DAIRY PKWY",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640145493",
            "telephone_number": "816-251-6100",
            "fax_number": "816-347-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NE ADAMS DAIRY PKWY",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640145493",
            "telephone_number": "816-251-6100",
            "fax_number": "816-347-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TARA",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2004023907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Springs, MO

Sources for this page

Verify at the official NPI Registry.