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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

KELLY J CLARK M.D.
NPI 1063450377
Psychiatry & Neurology - Psychiatry in Danville, PA

Active since June 02, 2006PECOS Enrolled
100 N ACADEMY AVE, DANVILLE, PA 17822(570) 271-6516(570) 271-5814 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kelly J Clark M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY J CLARK M.D. (NPI 1063450377) is an individual psychiatry provider in Danville, Pennsylvania, licensed in Pennsylvania (MD458823) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1989).

NPPES Registry Identity

NPI1063450377
Entity TypeIndividualFemale
Primary Taxonomy2084P0800X
Provider Legal NameKELLY J CLARKCredential: M.D.
Location Address100 N ACADEMY AVEDanville, PA 17822-9800
Mailing Address100 N Academy AveDanville, PA 17822-4903 · (570) 271-6516 · Fax (570) 271-5814
Phone(570) 271-6516
Fax(570) 271-5814
Sole ProprietorNo
Medical School CMSOtherGraduated 1989
Enumeration DateJune 2, 2006
Last NPPES UpdateJuly 13, 2026
NPPES CertifiedFebruary 19, 2026
✔ NPI 1063450377 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in PA · MD458823
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
100 N ACADEMY AVE, Danville, PA 17822
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly J Clark M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5597713578
PECOS Enrollment IDI20260328000393
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17822 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$166.87 typical visit price
range $54.64 – $166.87
Typical copayment $41.71 (range $13.66 – $41.71)
Most-billed visit code 99205
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TARA JEAN LOUX MD
Surgery (Pediatric Surgery)
100 N ACADEMY AVE
DANVILLE, PA 17822
Montour County (570) 214-7967
MS. DENISE K HACKMAN RD, LDN
Dietitian, Registered
100 N ACADEMY AVE
DANVILLE, PA 17822
Montour County (570) 271-5332
DR. DANIEL CARROLL GEARY MD
Emergency Medicine
100 N ACADEMY AVE
DANVILLE, PA 17822
Montour County (570) 271-6212
MS. MONISA DEANNE WAGNER
Physician Assistant
100 N ACADEMY AVE
DANVILLE, PA 17822
Montour County (570) 271-7910
JESSICA LYNN CARNEY
Pediatrics
100 N ACADEMY AVE
DANVILLE, PA 17822
Montour County (570) 271-7910
CHRISTIE BUONPANE
Surgery (Pediatric Surgery)
100 N ACADEMY AVE
DANVILLE, PA 17822
Montour County (570) 271-6211
MAURA ELIZABETH GABLE D.O.
Pediatrics (Neonatal-Perinatal Medicine)
100 N ACADEMY AVE
DANVILLE, PA 17822
Montour County (570) 271-7910
ROSLYN MARIE FEASTER
Nurse Anesthetist, Certified Registered
100 N ACADEMY AVE
DANVILLE, PA 17822
Montour County (570) 271-6211

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Clark's NPI number?

The NPI number for Kelly Clark is 1063450377. It was assigned to this individual provider in the NPPES registry on June 2, 2006.

Where is Kelly Clark located?

Kelly Clark practices at 100 N Academy Ave, Danville, PA 17822. The listed phone number is (570) 271-6516.

What is Kelly Clark's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Kelly Clark enrolled in Medicare?

Yes. Kelly Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kelly Clark was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.