Kimberly Clark, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP08910 Issued in LA

Practice address

11251 Westwood Ave
Denham Springs, LA 70726-6947

Phone

(225) 937-9653

NPI assigned

Jul 22, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Parish State Emergency Physicians LLCGroup PAC ID 5193252203, 25 clinicians

Cross Lake Emergency Group, LLCGroup PAC ID 5395096440, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

Merit-based Incentive Payment System (MIPS)

Final score

87.29 of 100Reported as group

Quality

76.46

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Aspire Health Services

  • Family Nurse Practitioner
  • Baton Rouge, LA
  • NPI 1083254890
  Medicare reassignment NPD Authorized official
• Cross Lake Emergency Group, LLC

  • Emergency Medicine Physician
  • Shreveport, LA
  • NPI 1013497114
  Medicare reassignment Care Compare group NPD
• Parish State Emergency Physicians LLC

  • Emergency Medicine Physician
  • New Iberia, LA
  • NPI 1023832870
  Medicare reassignment Care Compare group NPD
• Coolidge Emergency Group LLC

  • Emergency Medicine Physician
  • Lafayette, LA
  • NPI 1801140934
  Medicare reassignment NPD
• Foucher Emergency Group LLC

  • Emergency Medicine Physician
  • New Orleans, LA
  • NPI 1871879007
  Medicare reassignment NPD
• Independence Emergency Group LLC

  • Emergency Medicine Physician
  • Metairie, LA
  • NPI 1528384773
  Medicare reassignment NPD
• Kenner Emergency Group LLC

  • Emergency Medicine Physician
  • Kenner, LA
  • NPI 1013986546
  Medicare reassignment NPD
• Main Street Emergency Group LLC

  • Emergency Medicine Physician
  • New Iberia, LA
  • NPI 1750796041
  Medicare reassignment NPD
• St. John Emergency Group LLC

  • Emergency Medicine Physician
  • La Place, LA
  • NPI 1265401509
  Medicare reassignment NPD
• Journey Through Life, LLC

  • Community/Behavioral Health Agency
  • Baton Rouge, LA
  • NPI 1417200395
  NPD (past)
• R.T. Royal Group LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baton Rouge, LA
  • NPI 1255705828
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Willis Knighton Medical Center, Inc.

  dba WK Bossier Health Center

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba Willis Knighton South Hospital

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba WK Pierremont Health Center

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1780037994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11251 WESTWOOD AVE",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707266947",
            "telephone_number": "225-937-9653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11251 WESTWOOD AVE",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707266947",
            "telephone_number": "225-937-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KIMBERLY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-22",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP08910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thiravat Choojitarom, M.D.
• Victor H Chou, MD
• Ankur P Chudasama
• Ashley Clark
• Gordon H Clark, MD
• Cmbroggi LLC
• Bonnie Phillpott Cobb, MPT
• Roy Cobb III
• Haylee Marie Colclough
• Melissa K Cole, ABA

• Family Nurse Practitioner in Denham Springs, LA
• Providers in Denham Springs, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.