DR. KELSEY NICOLE CLARK DO NPI 1962080390

NPI Information

  • NPI: 1962080390
  • Provider Name: DR. KELSEY NICOLE CLARK, DO
  • Classification: Emergency Medicine - 207P00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 651 WILLOW GROVE ST
    HACKETTSTOWN, NJ
    ZIP 07840
  • Phone: (908) 852-5100

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NPI Details

DR. Kelsey Nicole Clark, DO is an emergency medicine in Hackettstown, NJ with 5 years of experience. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. DR. Kelsey Nicole Clark, DO NPI is 1962080390. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: WEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE
Graduation Year:2021

The provider's business location address is:

651 WILLOW GROVE ST
HACKETTSTOWN, NJ
ZIP 07840-799
Phone: (908) 852-5100

The NPI 1962080390 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 3/29/2021 and was last updated on 8/17/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207P00000XEmergency Medicine25MB12242400NEW JERSEYYes

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: 11/21/2025

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