JOHN R CLARK MD
NPI 1154451425
Emergency Medicine in Georgetown, KY

Q: What is John Clark's NPI number?

The NPI number for John Clark is 1154451425. It was assigned to this individual provider in the NPPES registry on March 6, 2007.

Q: What is John Clark's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for John Clark was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 06, 2007PECOS Enrolled

1140 LEXINGTON RD, GEORGETOWN, KY 40324(502) 868-1100 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About John R Clark Md NPPES

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

JOHN R CLARK MD (NPI 1154451425) is an individual emergency medicine provider in Georgetown, Kentucky, licensed in Kentucky (20185) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154451425

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameJOHN R CLARKCredential: MD

Location Address1140 LEXINGTON RDGeorgetown, KY 40324-9330

Mailing Address1431 Centerpoint Blvd, Suite 100Knoxville, TN 37932-1984 · (865) 985-7068

Phone(502) 868-1100

Sole ProprietorNo

Enumeration DateMarch 6, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1154451425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in KY · 20185

Definition

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.

1140 LEXINGTON RD, Georgetown, KY 40324

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Other Identifiers 3

Medicare ID-Type Unspecified0954301KY

Medicare UPIND32696KY

Medicaid64201858KY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John R Clark Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show John Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southeastern Emergency Physicians LLC

51 mi

Emergency Medicine

989 MEDICAL PARK DR
Maysville, KY 41056

Reassigned Medicare billing, Kentucky enrollment
828 clinicians in this Medicare group

NPI 1356379382 (606) 759-5311

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40324 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

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

Most-billed visit code 99214

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. KENT EDWARD TAYLOR M.D.

Internal Medicine (Medical Oncology)

1140 LEXINGTON RD, SUITE 202
GEORGETOWN, KY 40324

Scott County (502) 868-1100

TAYLOR BOGGS BSN, RN

Student in an Organized Health Care Education/Training Program