K. CLARK FAMILY MEDICAL PLLC
NPI 1700566577
Nurse Practitioner - Family in Queen Creek, AZ
About K. Clark Family Medical Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
K. CLARK FAMILY MEDICAL PLLC (NPI 1700566577) is a healthcare organization registered as a family in Queen Creek, Arizona and active in the NPI registry since July 2023. The organization lists Kailynn Clark, Provider, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
K. Clark Family Medical Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to K. Clark Family Medical PLLC, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 K. Clark Family Medical PLLC's NPI number?
The NPI number for K. Clark Family Medical PLLC is 1700566577. It was assigned to this organization in the NPPES registry on July 18, 2023.
Where is K. Clark Family Medical PLLC located?
K. Clark Family Medical PLLC is located at 19938 E Carriage Way, Queen Creek, AZ 85142. The listed phone number is (480) 518-5251.
What is K. Clark Family Medical PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is K. Clark Family Medical PLLC enrolled in Medicare?
Yes. K. Clark Family Medical PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through K. Clark Family Medical PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Nurse Practitioner, reassign their Medicare billing to K. Clark Family Medical PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for K. Clark Family Medical PLLC was last updated on May 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# K. Clark Family Medical Pllc · NPI 1700566577
Family organization in Queen Creek, Arizona. Organization record, active in the CMS NPPES registry since July 18, 2023.
## Identity
- **NPI:** 1700566577 (Entity type: Organization)
- **Enumerated:** July 18, 2023
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Kailynn Clark, PROVIDER
## Practice location
- **Address:** 19938 E CARRIAGE WAY, Queen Creek, AZ 85142-4907
- **Phone:** (480) 518-5251
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 11, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1700566577) · Data from the CMS NPPES public registry.