Kimberly Ann Clark

Primary specialty

Rehabilitation Registered NurseTaxonomy code 163WR0400X

License

1081271 Issued in KY

Practice address

151 The Landings
Taylorsville, KY 40071-9521

Phone

(502) 445-8660

NPI assigned

Jun 10, 2021

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 10, 2021.

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1962079665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 THE LANDINGS",
            "city": "TAYLORSVILLE",
            "state": "KY",
            "postal_code": "400719521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 THE LANDINGS",
            "city": "TAYLORSVILLE",
            "state": "KY",
            "postal_code": "400719521",
            "telephone_number": "502-445-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "KY",
            "license": "1081271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Alan Bormann, DMD
• Patrick Daniel Bray, PT
• Elois Broughton, R.PH.
• Lisa Anne Brumit, LPCC
• Care Links
• Cierra Connelley, APRN-CNP, PMHNP-BC
• Thomas Cecil Crain, M.D.
• Creekside Family Medical Center,PSC
• Sally L Crespo
• Danan L Hall Chiropractic PLLC

• All providers in Taylorsville, KY
• Rehabilitation Registered Nurse in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.