Active NPI
Patricia K Stark, NBC-HIS
- Hearing Instrument Specialist
- Clinton, IA
National Provider Identifier
1821235268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 00312
- Practice address
- 206 4TH Ave S
Clinton, IA 52732-4311 - Phone
- (563) 242-7852
- NPI assigned
- Jan 7, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 00312 | IA | Primary |
Addresses
Primary practice location
206 4TH Ave S
Clinton, IA 52732-4311
Mailing address
206 4TH Ave S
Clinton, IA 52732-4311
Phone (563) 242-7852
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699871947 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00312 | IA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Killean Hearing LLC | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231286400000",
"number": "1821235268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 4TH AVE S",
"city": "CLINTON",
"state": "IA",
"postal_code": "527324311",
"telephone_number": "563-242-7852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 4TH AVE S",
"city": "CLINTON",
"state": "IA",
"postal_code": "527324311",
"telephone_number": "563-242-7852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STARK",
"first_name": "PATRICIA",
"middle_name": "K",
"credential": "NBC-HIS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-07",
"last_updated": "2009-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Hearing Instrument Specialist",
"state": "IA",
"license": "00312",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1699871947",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clinton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.