KERRY A CLARK NP
NPI 1861436362
Nurse Practitioner - Family in Providence, RI
About Kerry A Clark Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KERRY A CLARK NP (NPI 1861436362) is an individual family provider in Providence, Rhode Island, licensed in Rhode Island (APRN00233) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kerry A Clark Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kerry Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Providence, RI 02905
- Reassigned Medicare billing, Rhode Island enrollment
- 222 clinicians in this Medicare group
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 02905 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
PROVIDENCE, RI 02905
PROVIDENCE, RI 02905
PROVIDENCE, RI 02905
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 Kerry Clark's NPI number?
The NPI number for Kerry Clark is 1861436362. It was assigned to this individual provider in the NPPES registry on June 15, 2006.
Where is Kerry Clark located?
Kerry Clark practices at 2 Dudley St Ste 200, Providence, RI 02905. The listed phone number is (401) 457-1540.
What is Kerry Clark's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kerry Clark enrolled in Medicare?
Yes. Kerry Clark is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kerry Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kerry Clark reassigns Medicare benefits to University Orthopedics, Inc. (Providence, RI). The 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 Kerry Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kerry Clark was last updated on March 17, 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.
# Kerry A Clark, NP · NPI 1861436362
Family physician in Providence, Rhode Island. Individual provider, active in the CMS NPPES registry since June 15, 2006.
## Identity
- **NPI:** 1861436362 (Entity type: Individual)
- **Enumerated:** June 15, 2006
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** APRN00233 (Rhode Island)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2 DUDLEY ST, STE 200, Providence, RI 02905-3236
- **Phone:** (401) 457-1540
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** University Orthopedics, Inc. (NPI 1235181041, Providence, RI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 17, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1861436362) · Data from the CMS NPPES public registry.