Kathleen Linton Clark, APRN-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN241302 Issued in GA

Practice address

3200 Downwood Cir NW
Ste 550
Atlanta, GA 30327-1624

Phone

(404) 351-0205

Fax

(404) 351-4187

NPI assigned

Dec 15, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

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.

• Atlanta Neuroscience Institute, Inc.

  • Neurology Physician
  • Atlanta, GA
  • NPI 1184847345
  Medicare reassignment NPD

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495065600000",
    "number": "1912236209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 DOWNWOOD CIR NW",
            "address_2": "STE 550",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303271624",
            "telephone_number": "404-351-0205",
            "fax_number": "404-351-4187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 DOWNWOOD CIR NW",
            "address_2": "STE 550",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303271624",
            "telephone_number": "404-351-0205",
            "fax_number": "404-351-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATHLEEN",
        "middle_name": "LINTON",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-15",
        "last_updated": "2017-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN241302",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN241302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003188941A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Javeya Clark, OD
• Jeffrey Ira Clark, MD
• Jessica Taylor Clark, PT, DPT
• Johanna J Clark, CSA
• Julia Clark, LMSW
• Kathy Clark, CAT
• Kimberly Anne Clark, RBT
• Kristiana Alivia Clark, NP-C
• Laurie Anne Clark, PA-C
• Lyndsey Clark

• Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.