Kelly Ann Clark
Kelly Ann Clark is a Family Nurse Practitioner provider (Nurse Practitioner) practicing in Bethany, MO, registered in the NPPES registry with NPI 1164062972 since 2020.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1164062972 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Kelly Ann Clark |
| Sex | Female |
| Practice address | 3202 MILLER ST, Bethany, MO, 64424 |
| Phone | 6604253154 |
| Fax | 6604256663 |
| Enumeration date | 2020-01-09 |
| Last updated in NPPES | 2021-03-18 |
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 363LF0000X | Family Nurse Practitioner | Primary | 2020000768 | MO |
| 207Q00000X | Family Medicine Physician | Secondary | 2020000768 | MO |
Copy-ready billing details
Provider: Kelly Clark NPI: 1164062972 Taxonomy: 363LF0000X (Family Nurse Practitioner) Address: 3202 MILLER ST, Bethany, MO, 64424
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1154328219 | Hansa Patel | Individual | Family Medicine Physician | Bethany, MO |
| 1639176365 | Natu Patel | Individual | Family Medicine Physician | Bethany, MO |
| 1255303681 | Tamula Maxwell | Individual | Physician Assistant | Bethany, MO |
| 1851496863 | Bethany Medical Rural Health Clinic | Organization | Rural Health Clinic/Center | Bethany, MO |
| 1548385735 | Amy Harris | Individual | Family Nurse Practitioner | Bethany, MO |
| 1154645745 | Harrison County Community Hospital District | Organization | Rural Health Clinic/Center | Bethany, MO |
| 1053601716 | Cephas Paniamogan | Individual | Family Nurse Practitioner | Bethany, MO |
| 1063704161 | Kenneth Lambert | Individual | Family Medicine Physician | Bethany, MO |
Verify this record
Cross-check NPI 1164062972 against the authoritative CMS record: view Kelly Ann Clark on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is the NPI number for Kelly Clark?
Where does Kelly Clark practice?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2021-03-18.