KYLIE A STARK
NPI 1922760776
Counselor - Professional in Dickinson, ND

Q: What is Kylie Stark's NPI number?

The NPI number for Kylie Stark is 1922760776. It was assigned to this individual provider in the NPPES registry on October 8, 2021.

Q: What is Kylie Stark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Kylie Stark was last updated on July 24, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 08, 2021PECOS EnrolledAccepts Medicare Assignment

1463 I94 BUSINESS LOOP E, DICKINSON, ND 58601(701) 227-7506 Get Directions Write a Review

NPPES record last updated: July 24, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 24, 2024, Jul 27, 2022, Oct 8, 2021 (3 updates tracked since 2021).

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About Kylie A Stark NPPES

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

KYLIE A STARK (NPI 1922760776) is an individual professional provider in Dickinson, North Dakota, licensed in North Dakota (1211-7-1-22) and active in the NPI registry since October 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1922760776

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameKYLIE A STARK

Location Address1463 I94 BUSINESS LOOP EDickinson, ND 58601-6434

Mailing Address1463 I94 Business Loop EDickinson, ND 58601-6434 · (701) 227-7506

Phone(701) 227-7506

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateOctober 8, 2021

Last NPPES UpdateJuly 24, 20243 updates tracked since enumeration

NPPES CertifiedJuly 24, 2024

✔ NPI 1922760776 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in ND · 1211-7-1-22

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

Also ListedSpecialistTaxonomy 174400000X

1463 I94 BUSINESS LOOP E, Dickinson, ND 58601

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Sanford Health Plan.Insurance ›

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

Kylie A Stark 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 ID4284161621

PECOS Enrollment IDI20241223003153

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.

RICHARD N DEMOLEN PSYD

Psychologist