KEVIN ROBERT CLARK (NPI# 1508077090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508077090 |
| Entity Type | Individual |
| Full Name | KEVIN ROBERT CLARK |
| Credential | M.D. |
| Practice Address |
3211 Woodland Ave Kansas City MO 64109-2073 |
| Practice Telephone | 8169316500 |
| Mailing Telephone | 8169316500 |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2016-03-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
2012012826 | MO | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598294001 | Kevin John Clark | Chiropractor | 2815 83rd St, Darien, IL 60561-1660 | 2017-06-08 |
| 1124402516 | Kevin Michael Clark | Dentist | 8 Inwood Peak, San Antonio, TX 78248-1654 | 2015-07-15 |
| 1275976276 | Kevin P Clark | Pharmacist | 215 Sixth Street, Hotchkiss, CO 81419-0928 | 2013-04-10 |
| 1265736508 | Kevin Clark | Acupuncturist | 415 Route 34, Suite 210, Colts Neck, NJ 07722-2522 | 2010-12-30 |
| 1033361381 | Kevin Dewitt Clark | Acupuncturist | 130 N Dixie Hwy, Hollywood, FL 33020-6704 | 2008-10-17 |
| 1891859278 | Kevin Landis Clark | Optometrist | 10415 Gateway Blvd W, El Paso, TX 79925-7905 | 2006-12-20 |
| 1609934397 | Kevin John Clark | Counselor | 251 E 5th St, Brooklyn, NY 11218-2403 | 2006-12-05 |
| 1912947144 | Kevin Grafton Clark | Optometrist | 5310 Highway 25, Suite 5, Flowood, MS 39232-6148 | 2006-06-07 |
| 1235127291 | Kevin N Clark | Surgery | 425 Medical Dr, Ste 101, Bountiful, UT 84010-4945 | 2005-10-12 |
| 1497376958 | Kevin P. Clark Sr. | Social Worker | 30 Harriman Dr, Goshen, NY 10924-2410 | 2020-05-06 |
| Street Address |
3211 WOODLAND AVE |
| City | KANSAS CITY |
| State | MO |
| Zip Code | 64109-2073 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053451591 | Rediscover | Clinic/Center | 3211 Woodland Ave, Kansas City, MO 64109-2073 | 2007-02-07 |
| 1861090037 | Breonna Lynne Lindsey | Social Worker | 3211 Woodland Ave, Kansas City, MO 64109-2073 | 2020-10-11 |
| 1942842489 | Chrystal Yow | Social Worker | 3211 Woodland Ave, Kansas City, MO 64109-2073 | 2019-10-16 |
| 1205490356 | Ruth Anne Fink | Social Worker | 3211 Woodland Ave, Kansas City, MO 64109-2073 | 2019-04-24 |
| 1003373044 | Dhruti Umang Shah | Counselor | 3211 Woodland Ave, Kansas City, MO 64109-2073 | 2019-02-26 |
| 1346716602 | Rita Nelson | Licensed Practical Nurse | 3211 Woodland Ave, Kansas City, MO 64109 | 2018-10-15 |
| 1609351436 | Sun Young Lee | Counselor | 3211 Woodland Ave, Kansas City, MO 64109-2073 | 2018-09-27 |
| 1588147128 | Heidi Rose White | Counselor | 3211 Woodland Ave, Kansas City, MO 64109-2073 | 2018-09-10 |
| 1164905055 | Niesha Miser | Counselor | 3211 Woodland Ave, Kansas City, MO 64109-2073 | 2018-09-07 |
| 1023506490 | Laurie Ann Wells | Registered Nurse | 3211 Woodland Ave, Kansas City, MO 64109-2073 | 2018-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184255382 | Lindsey June Orlowski | Counselor | 3216 Gillham Rd, Suite 210, Kansas City, MO 64109 | 2020-01-28 |
| 1689227324 | Matthew Elbridge Langston | Counselor | 3211 Woodland Ave., Kansas City, MO 64109 | 2019-07-22 |
| 1508215104 | Careplus Home Care, LLC | Home Health | 2418 E Linwood Blvd, 302d, Kansas City, MO 64109 | 2016-06-06 |
| 1316318058 | Rosalind Carter | Registered Nurse | 3201 Woodland Ave, Kansas City, MO 64109 | 2015-10-07 |
| 1083083018 | Shantai Mccray | Counselor | 2420 E. Linwood Blvd, Suite 300 C, Kansas City, MO 64109 | 2015-09-21 |
| 1982028296 | Patricia Marie Hoard | Community Health Worker | 3647 Troost Ave, Kansas City, MO 64109 | 2014-02-06 |
| 1184045171 | Uzazi Village | Registered Nurse | 3647 Troost, Kansas City, MO 64109 | 2013-12-18 |
| 1285984583 | Bare Essentials Home Care Inc. | In Home Supportive Care | 3200 Wayne Ave., Suite 103, Kansas City, MO 64109 | 2012-09-13 |
| 1912139296 | Lisa Denise Powell | Homemaker | 3723 Park Ave, 3723 Park Ave, Kasas City, MO 64109 | 2009-08-20 |
| 1821596032 | Kacie Wade Sterling | Speech-Language Pathologist | 2901 Troost Ave, Kansas City, MO 64109 | 2018-01-23 |
| Find all providers in zip 64109 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558857086 | Hcm Group, LLC | Family Medicine | 36 Doctors Park Ste 2, Cape Girardeau, MO 63703-4904 | 2018-07-09 |
| 1114498698 | St. Kolbe-puckett Center for Healing Inc | Family Medicine | 210 N 7th St, Saint Joseph, MO 64501-1906 | 2018-12-10 |
| 1306395645 | Rosenblatt Clinic LLC | Family Medicine | 4621 S Shrank Dr, Suite B, Independence, MO 64055-5453 | 2016-09-28 |
| 1134239056 | Robert L. Elworth | Family Medicine | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2006-08-30 |
| City | KANSAS CITY |
| Zip Code | 64109 |
Please comment or provide details below to improve the information on KEVIN ROBERT CLARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.