Kristyn Lyn Clark

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3012305 Issued in KY

Practice address

2021 Hikes LN
Louisville, KY 40218-4817

Phone

(502) 446-5555

Fax

(502) 394-3673

NPI assigned

May 2, 2018

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.11 of 100Reported as group

Quality

63.34

Promoting interoperability

100

Improvement activities

40

Cost

73.68

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristyn.clark@krogerhealth.eclinicaldirectplus.com

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.

• Community Medical Associates, Inc.

  • Multi-Specialty Clinic/Center
  • Louisville, KY
  • NPI 1306983762

  Family, KY

  Medicare reassignment Care Compare group NPD
• Kiosk Medicine Kentucky LLC

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1205885035

  Family, KY

  Medicare reassignment NPD
• Community Medical Associates, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1588614994
  NPD
• Community Medical Associates, Inc.

  • Neurological Surgery Physician
  • Louisville, KY
  • NPI 1922288760
  NPD (past)

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

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1982193298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 HIKES LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402184817",
            "telephone_number": "502-446-5555",
            "fax_number": "502-394-3673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KRISTYN",
        "middle_name": "LYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-02",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3012305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kclark43377@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "3991 Dutchmans Ln Ste 300",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "40207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/",
            "affiliation": "N",
            "address_1": "3991 Dutchmans Ln Ste 300",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "40207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joseph Clark, LCADC, CSW
• Joshua Clark
• Joshua Scott Clark, MS, OTR/L
• Katie Clark, OD
• Kellsy Clark
• Krystal Clark
• Kylie Clark, DPT
• Latoya Shaneese Clark, PHARMD
• Laura DL Clark, MD
• Leah Clark, RBT

• All providers in Louisville, KY
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; 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.