Mary Kathryn Stark, RN, MS, FNP, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

200750019NP Issued in OR

Practice address

3579 Franklin Blvd
Eugene, OR 97403-2356

Phone

(541) 344-9411

NPI assigned

Feb 24, 2007

Last updated

Jun 10, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other names 1

• Mary Kathryn Derieg Former name

Medicare fee-for-service enrollment

Enrolled in OR, CA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner, Registered Nurse

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stark Medical Group PC

  • Family Nurse Practitioner
  • Ontario, OR
  • NPI 1063754208
  Medicare reassignment NPD
• Planned Parenthood Mar Monte, Inc

  • Community Health Clinic/Center
  • Stockton, CA
  • NPI 1174579957
  Medicare reassignment
• Planned Parenthood Mar Monte, Inc

  • Community Health Clinic/Center
  • San Jose, CA
  • NPI 1043263189
  NPD
• Planned Parenthood Mar Monte, Inc.

  dba Mar Monte Community Clinic

  • Community Health Clinic/Center
  • San Jose, CA
  • NPI 1598536971
  NPD
• Planned Parenthood of the Columbia/Willamette, Inc.

  dba Planned Parenthood Columbia Willamette

  • Multi-Specialty Clinic/Center
  • Portland, OR
  • NPI 1053311860
  NPD (past)

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

{
    "created_epoch": "1172275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1871629055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3579 FRANKLIN BLVD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974032356",
            "telephone_number": "541-344-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3579 FRANKLIN BLVD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974032356",
            "telephone_number": "541-344-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "credential": "RN, MS, FNP, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-24",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200750019NP",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "704767",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "895557",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95037843",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60171571",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "DERIEG",
            "middle_name": "KATHRYN",
            "credential": "RN, MS, FNP, DNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren Stapleton
• Karen Jo Stark-Bredeweg, L.C.S.W
• Darby Stark
• Hudsen Joseph-Palmer Stark
• Kathleen Stark, CADC II
• Sara Callender Stark, PHD
• Sarah Stark
• Mary Starkovich, BSN
• Marilyn Arlene Starks, LPN
• Sara Starlin

• Family Nurse Practitioner in Eugene, OR
• Providers in Eugene, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; 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.