1. Home
  2. Directory
  3. Utah
  4. Salt Lake City
  5. Pediatrics
  6. NPI Profile

NICOLE CLARK MD
NPI 1881176410
Pediatrics - Pediatric Emergency Medicine in Salt Lake City, UT

Active since August 30, 2018PECOS Enrolled
295 S CHIPETA WAY, SALT LAKE CITY, UT 84108(801) 581-2121 Get Directions Write a Review

NPPES record last updated: May 28, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 28, 2026, Aug 30, 2018 (2 updates tracked since 2018).

About Nicole Clark Md NPPES

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

NICOLE CLARK MD (NPI 1881176410) is an individual pediatric emergency medicine provider in Salt Lake City, Utah, licensed in Utah (13361586-1205) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS and maintains a secondary practice location in Portland.

NPPES Registry Identity

NPI1881176410
Entity TypeIndividualFemale
Primary Taxonomy2080P0204X
Provider Legal NameNICOLE CLARKCredential: MD
Location Address295 S CHIPETA WAYSalt Lake City, UT 84108-1287
Mailing Address295 S Chipeta WaySalt Lake City, UT 84108-1287 · (801) 581-2121
Phone(801) 581-2121
Sole ProprietorNo
Enumeration DateAugust 30, 2018
Last NPPES UpdateMay 28, 20262 updates tracked since enumeration
NPPES CertifiedMay 28, 2026
✔ NPI 1881176410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0204X
License✔ Licensed in UT · 13361586-1205
Definition
A pediatrician who has special qualifications to manage emergencies in infants and children.
295 S CHIPETA WAY, Salt Lake City, UT 84108
Open in Google Maps ↗

Other Names 1

Former Name (1)Nicole A Barney

Secondary Practice Location 1

Location 13181 SW Sam Jackson Park RdPortland, OR 97239-3011 · Phone (503) 418-2053

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole 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.

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.

KELLY STOUT PHD
Psychologist
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 213-3469
MALIA MONICA OLSON
Genetic Counselor, MS
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7400
ALEX NICOLE HESS NNP-BC
Nurse Practitioner (Neonatal)
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 558-8276
DR. DAWN M. MAXEY MD
Pediatrics (Pediatric Critical Care Medicine)
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 581-2121
KATHRYN L. SONGER MD
Pediatrics (Pediatric Critical Care Medicine)
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7572
LAUREN MOLLY STERNBERG MD
Student in an Organized Health Care Education/Training Program
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 662-5700
RACHEL WILLIS
Nurse Practitioner (Neonatal)
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7400
DR. ERIN L. GOSEKAMP DO, MPH, MS
Pediatrics (Pediatric Critical Care Medicine)
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7572

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 Nicole Clark's NPI number?

The NPI number for Nicole Clark is 1881176410. It was assigned to this individual provider in the NPPES registry on August 30, 2018. The provider is also known as Nicole A Barney.

Where is Nicole Clark located?

Nicole Clark practices at 295 S Chipeta Way, Salt Lake City, UT 84108. The listed phone number is (801) 581-2121.

What is Nicole Clark's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Is Nicole Clark enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Nicole Clark was last updated on May 28, 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.