Kimberley Carol Clark-Paul, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301404907 Issued in MI

Practice address

1221 Richardson St
Port Huron, MI 48060-3548

Phone

(810) 982-1111

Fax

(810) 982-8848

NPI assigned

Aug 30, 2006

Last updated

Feb 27, 2018By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Wayne State University School of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McLaren Port HuronGroup PAC ID 9931018702, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Home Health Home health agency, Clinton Township, MI, CCN 237172
• McLaren Port Huron Hospital, Port Huron, MI, CCN 230216

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11357/brand/3/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/22279/brand/1/csg/1/fhir/r4

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.

• McLaren Port Huron

  dba Port Huron Hospital Physician GRP

  • Psychiatry Physician
  • Port Huron, MI
  • NPI 1386888170
  Medicare reassignment Care Compare group NPD
• McLaren Port Huron

  • Family Medicine Physician
  • Port Huron, MI
  • NPI 1619355930
  NPD
• Hope Surgical, PLLC

  • Surgery Physician
  • Port Huron, MI
  • NPI 1558972794
  NPD (past)
• M. Azhar Ali MD PC

  • Plastic Surgery Physician
  • Birmingham, MI
  • NPI 1013033976
  NPD (past)
• Physician Healthcare Network, PC

  • Urgent Care Clinic/Center
  • Marysville, MI
  • NPI 1093921074
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• McLaren Health Management Group

  dba McLaren Home Health

  • Home Health Agency
  • Clinton TWP, MI
  • NPI 1609989805
  Care Compare affiliation
• McLaren Port Huron

  • General Acute Care Hospital
  • Port Huron, MI
  • NPI 1982685384
  Care Compare affiliation

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1952410987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 WASHINGTON AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603555",
            "telephone_number": "810-982-1111",
            "fax_number": "810-982-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 RICHARDSON ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603548",
            "telephone_number": "810-982-1111",
            "fax_number": "810-982-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK-PAUL",
        "first_name": "KIMBERLEY",
        "middle_name": "CAROL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301404907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952410987",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Salwa Wadud Choudhury, PA-C
• Christopher M Rossow DDS PC
• Edward Cieslinski, LMSW, ACSW
• Stephanie Marie Ciner, RN
• Crystal Deeann Clapper
• Aaron Kenneth Clark, M.D.
• Mikaela Michele Clarke, MS, BCBA, LBA
• Katelyne Marie Click
• Alicia Marie Cline, RN
• Taylor Joseph Clinkscales

• Surgery Physician in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; 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.