KELLYANN T CLARK NP
NPI 1811249378
Nurse Practitioner - Adult Health in Falls Church, VA

Q: What is Kellyann Clark's NPI number?

The NPI number for Kellyann Clark is 1811249378. It was assigned to this individual provider in the NPPES registry on October 9, 2012.

Q: What is Kellyann Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Kellyann Clark was last updated on January 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 October 09, 2012PECOS EnrolledAccepts Medicare Assignment

3300 GALLOWS RD, FALLS CHURCH, VA 22042(703) 776-3359(703) 776-2338 Get Directions Write a Review

NPPES record last updated: January 27, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Kellyann T Clark Np NPPES

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

KELLYANN T CLARK NP (NPI 1811249378) is an individual adult health provider in Falls Church, Virginia, licensed in Virginia (0024170317) and active in the NPI registry since October 2012. She is enrolled in Medicare PECOS, is affiliated with Reston Hospital Center, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1811249378

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameKELLYANN T CLARKCredential: NP

Location Address3300 GALLOWS RDFalls Church, VA 22042-3307

Mailing Address3300 Gallows RdFalls Church, VA 22042-3307 · (703) 776-3359 · Fax (703) 776-2338

Phone(703) 776-3359

Fax(703) 776-2338

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateOctober 9, 2012

Last NPPES UpdateJanuary 27, 2022

✔ NPI 1811249378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in VA · 0024170317

3300 GALLOWS RD, Falls Church, VA 22042

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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

Kellyann T Clark Np 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 ID8224288345

PECOS Enrollment IDI20140904001924

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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

85 services84 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Reston Hospital Center

Acute Care Hospitals · Reston, VA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490107

Location1850 Town Center ParkwayReston, VA 20190 · Fairfax County

Emergency services

Stonesprings Hospital Center

Acute Care Hospitals · Dulles, VA

OwnershipProprietary

CMS Certification Number490145

Location24440 Stone Springs BoulevardDulles, VA 20166 · Loudoun County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22042 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

$100.31 typical visit price

range $65.18 – $194.86

Typical copayment $25.07 (range $16.29 – $48.71)

Most-billed visit code 99203

Established Patient

$113.72 typical visit price

range $21.40 – $158.88

Typical copayment $28.43 (range $5.35 – $39.72)

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.

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