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DR. KATIE MARIE CLARK DO
NPI 1457047490
Student in an Organized Health Care Education/Training Program in Beavercreek, OH

Active since April 13, 2023PECOS Enrolled
725 UNIVERSITY BLVD, BEAVERCREEK, OH 45324(937) 775-7792 Get Directions Write a Review

NPPES record last updated: June 2, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 2, 2026, Apr 13, 2023 (2 updates tracked since 2023).

About Dr. Katie Marie Clark Do NPPES

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

DR. KATIE MARIE CLARK DO (NPI 1457047490) is an individual student in an organized health care education/training program in Beavercreek, Ohio and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1457047490
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. KATIE MARIE CLARKCredential: DO
Location Address725 UNIVERSITY BLVDBeavercreek, OH 45324-2640
Mailing Address725 University BlvdBeavercreek, OH 45324-2640
Phone(937) 775-7792
Sole ProprietorNo
Enumeration DateApril 13, 2023
Last NPPES UpdateJune 2, 20262 updates tracked since enumeration
NPPES CertifiedJune 2, 2026
✔ NPI 1457047490 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
725 UNIVERSITY BLVD, Beavercreek, OH 45324
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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 (PECOS)

Dr. Katie Marie Clark Do 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.

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.

SAMANTHA ACHAUER MD
Student in an Organized Health Care Education/Training Program
725 UNIVERSITY BLVD
BEAVERCREEK, OH 45324
Greene County (937) 775-7792
DR. JOSEPH KEVIN GRIFFIN MD
Student in an Organized Health Care Education/Training Program
725 UNIVERSITY BLVD
FAIRBORN, OH 45324
Greene County (937) 775-7792
NIKHIL TEJ KURAPATI MD, MPH
Family Medicine
725 UNIVERSITY BLVD
BEAVERCREEK, OH 45324
Greene County (937) 245-7200
THERESIA GORDNIER
Family Medicine
725 UNIVERSITY BLVD
BEAVERCREEK, OH 45324
Greene County (937) 245-7200
DR. HARMINDER GREWAL MD
Family Medicine
725 UNIVERSITY BLVD
BEAVERCREEK, OH 45324
Greene County (937) 245-7200
GABRIELLE MARKLEY
Student in an Organized Health Care Education/Training Program
725 UNIVERSITY BLVD
BEAVERCREEK, OH 45324
Greene County (937) 245-7000
DAVID ANDREW ZEALLEY STUDENT
Psychiatry & Neurology (Psychiatry)
725 UNIVERSITY BLVD
BEAVERCREEK, OH 45324
Greene County (937) 775-7792
DR. JOHN BRODERICK
Student in an Organized Health Care Education/Training Program
725 UNIVERSITY BLVD
BEAVERCREEK, OH 45324
Greene County (937) 343-4310

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 Katie Clark's NPI number?

The NPI number for Katie Clark is 1457047490. It was assigned to this individual provider in the NPPES registry on April 13, 2023.

Where is Katie Clark located?

Katie Clark practices at 725 University Blvd, Beavercreek, OH 45324. The listed phone number is (937) 775-7792.

What is Katie Clark's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Katie Clark enrolled in Medicare?

Yes. Katie Clark is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Katie Clark was last updated on June 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.