NPIMap

Organization Active NPI

Clark Family Care, LLC

  • Family Medicine Physician
  • Kansas City, MO
National Provider Identifier
1831481688
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2004023907 Issued in MO
Legal business name
CLARK FAMILY CARE, LLC
Practice address
4240 Blue Ridge Blvd
Suite 611
Kansas City, MO 64133-1713
Phone
(816) 356-2020
Fax
(816) 356-2022
NPI assigned
May 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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

Authorized official

Name
Dr. Tara Clark, D.O.
Title
Physician/Owner
Phone
(816) 356-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 2004023907 MO Primary

Addresses

Primary practice location

4240 Blue Ridge Blvd
Suite 611
Kansas City, MO 64133-1713

Mailing address

4240 Blue Ridge Blvd
Suite 611
Kansas City, MO 64133-1713
Phone (816) 356-2020

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329696000000",
    "number": "1831481688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 BLUE RIDGE BLVD",
            "address_2": "SUITE 611",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641331713",
            "telephone_number": "816-356-2020",
            "fax_number": "816-356-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 BLUE RIDGE BLVD",
            "address_2": "SUITE 611",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641331713",
            "telephone_number": "816-356-2020",
            "fax_number": "816-356-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK FAMILY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-12",
        "last_updated": "2012-02-20",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "816-356-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2004023907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.