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KELLEY D. CLARK MD NPI 1073695045


NPI Information

NPI: 1073695045
Provider Name: KELLEY D. CLARK, MD
Classification: Obstetrics & Gynecology - 207VM0101X
Entity Type: Individual

Specialization: Maternal & Fetal Medicine

Organization: WELLSPAN MEDICAL GROUP

PECOS Registration: Yes

Address:
35 MONUMENT RD STE 202
YORK, PA
ZIP 17403
Phone: (717) 851-2722
Get Directions

Kelley D. Clark, MD is a maternal and fetal medicine obstetrics gynecology in York, PA with 34 years of experience. The provider is an obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies. Kelley D. Clark, MD NPI is 1073695045. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: KENTUCKY SCHOOL OF MEDICINE
Graduation Year:1990

The provider's business location address is:

35 MONUMENT RD STE 202
YORK, PA
ZIP 17403-074
Phone: (717) 851-2722
Fax: (717) 851-3127

The NPI 1073695045 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/19/2006 and was last updated on 4/23/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207VM0101XObstetrics & GynecologyMaternal & Fetal MedicineMD431748PENNSYLVANIAYes
2207VM0101XObstetrics & GynecologyMaternal & Fetal Medicine30720KENTUCKYNo
3207VM0101XObstetrics & GynecologyMaternal & Fetal Medicine0101259164VIRGINIANo
4207VM0101XObstetrics & GynecologyMaternal & Fetal Medicine40584TENNESSEENo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
164307200MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.