Active NPI
Emily Mossotti Clark, PA-C
- Physician Assistant
- Lexington, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA991
- Practice address
- 1218 S Broadway
Suite 310
Lexington, KY 40504-2759 - Phone
- (859) 219-0542
- Fax
- (859) 219-9433
- NPI assigned
- Jan 24, 2008
- Last updated
- Nov 4, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA991 | KY | Primary |
Addresses
Primary practice location
1218 S Broadway
Suite 310
Lexington, KY 40504-2759
Mailing address
1218 S Broadway
Suite 310
Lexington, KY 40504-2759
Phone (859) 219-0542
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100051790 | Medicaid | KY |
Other names 1
- Miss Emily Anne Mossotti
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Medical Ctr Dr
Springfield, OH 45504-2687
Phone (937) 523-1000
1977 Miamisburg Centerville Rd
Dayton, OH 45459-3811
Phone (937) 439-6000
3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8627
4000 Miamisburg Centerville Rd
Miamisburg, OH 45342-7615
Phone (937) 296-7227
630 Eaton Ave
Hamilton, OH 45013-2767
Phone (513) 867-2000
Hospital & facility affiliations
- Kettering Health Main Campus
- Soin Medical Center
- Kettering Health Dayton
- Kettering Health Miamisburg
- Springfield Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 77.41 of 100
- Quality
- 73.46
- Improvement activities
- 40
- Cost
- 73.34
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TC033 | KY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alliance Physicians Inc | Current | Accepting new patients | |
| Kettering Medical Center | Past | Accepting new patients |
Locations (25 of 40)
3535 Pentagon Blvd
Beavercreek, OH 45431
Phone (937) 702-4000
3371 Kemp Rd
Beavercreek, OH 45431
Phone (937) 320-3600
2510 Commons Blvd
Beavercreek, OH 45431
Phone (937) 223-2911
1023 S Main St
Centerville, OH 45458
Phone (937) 435-1982
101 E Alex Bell Rd
Ste 190
Dayton, OH 45459
Phone (937) 425-4020
6661 Clyo Rd
Dayton, OH 45459
Phone (937) 425-4000
3095 Dayton Xenia Rd
Ste 100
Dayton, OH 45434
Phone (937) 531-7902
6438 Wilmington Pike
Ste 120
Dayton, OH 45459
Phone (937) 558-3800
405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200
7740 Washington Village Dr
Ste 140
Dayton, OH 45459
Phone (937) 439-7420
450 Washington Jackson Rd
#F
Eaton, OH 45320
Phone (937) 456-8376
1250 W National Rd
Englewood, OH 45315
Phone (937) 558-3062
1045 Channingway Dr
Fairborn, OH 45324
Phone (937) 878-8644
100 Kettering Way
Franklin, OH 45005
Phone (937) 458-4700
909 E 2nd St
Ste C
Franklin, OH 45005
630 Eaton Ave
Hamilton, OH 45013
Phone (513) 867-2000
2449 Ross Millville Rd
Hamilton, OH 45013
Phone (513) 422-6516
1391 Main St
Hamilton, OH 45013
Phone (513) 867-9000
8701 Troy Pike
Huber Heights, OH 45424
Phone (937) 558-3309
3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221
3700 Southern Blvd
Ste 106
Kettering, OH 45429
Phone (937) 281-3840
424 E Stroop Rd
#B
Kettering, OH 45429
1745 E Stroop Rd
Kettering, OH 45429
Phone (937) 281-6340
3700 Southern Blvd
Ste 201
Kettering, OH 45429
Phone (855) 500-2873
540 Lincoln Park Blvd
Ste 100
Kettering, OH 45429
Phone (937) 299-0900
Interoperability endpoints
- eclark570460@direct.ketteringhealth.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Diagnostic Radiology Physician
- Kettering, OH
- NPI 1346299153
-
dba Kettering Health Medical Group
- Family Medicine Physician
- Kettering, OH
- NPI 1437125572
-
dba Collaborative Pharmacy Services
- Long Term Care Pharmacy
- Miamisburg, OH
- NPI 1205005063
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Soin Medical Center
- General Acute Care Hospital
- Beavercreek, OH
- NPI 1760764849
-
dba Mercy Health - Springfield Regional Medical Center
- General Acute Care Hospital
- Springfield, OH
- NPI 1144286402
-
dba Mercy Health - Lab Services, Springfield
- Clinical Medical Laboratory
- Springfield, OH
- NPI 1477217297
Hospital
-
dba Kettering Health Dayton
- General Acute Care Hospital
- Dayton, OH
- NPI 1053339507
-
dba Kettering Health Main Campus
- General Acute Care Hospital
- Kettering, OH
- NPI 1043233984
-
dba Kettering Health Miamisburg
- General Acute Care Hospital
- Miamisburg, OH
- NPI 1316966518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320364800000",
"number": "1821275520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1218 S BROADWAY",
"address_2": "SUITE 310",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405042759",
"telephone_number": "859-219-0542",
"fax_number": "859-219-9433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1218 S BROADWAY",
"address_2": "SUITE 310",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405042759",
"telephone_number": "859-219-0542",
"fax_number": "859-219-9433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "EMILY",
"middle_name": "MOSSOTTI",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-24",
"last_updated": "2011-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "PA991",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100051790",
"state": "KY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "EMILY",
"last_name": "MOSSOTTI",
"middle_name": "ANNE",
"prefix": "MISS",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.