DR. KATHY S CLARK (MD) – Diagnostic Radiology Physician, NPI 1952304701

DR. KATHY S CLARK (MD) is a healthcare provider. based in Indianapolis, Indiana. specializing in Diagnostic Radiology Physician. They hold the professional credentials MD. They hold a License No. 01036050A (IN). The NPI Number for DR. KATHY S CLARK (MD) is 1952304701

Main info

Female
40 Years Of Experience
Accepts Medicare Assignment
Name
DR. KATHY S CLARK (MD)
NPI
1952304701
Phone
(317) 328-5050
Address
5901 TECHNOLOGY CENTER DR
Enumeration Date
24 May 2005
Last Update Date
3 October 2016

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7656492511
Graduation Year
1986 (40 years ago)
PAC ID
0042260507
Group Practice PAC ID
1557331261
Professional Enrollment ID
I20050124000425
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:21State licenses:1Digital endpointsOther names

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Provider Addresses for DR. KATHY S CLARK (MD)

  • 5901, Technology Center Drive, Indianapolis, Boone County, Indiana, 46278, United States

    INDIANAPOLIS, IN 462786013

    Phone: (317) 328-5050

    Fax: (317) 328-5053

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-01-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050124000425IDiagnostic RadiologyINTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46278)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1557331261View full group profile
NameSpecialtyState
Diagnostic RadiologyIN
Diagnostic RadiologyNC
Diagnostic RadiologyIN
-IN
Diagnostic RadiologyOR
Diagnostic RadiologyIN

Reviews

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Frequently asked questions

What identifier follows DR. KATHY S CLARK (MD) across health systems?
The NPI 1952304701 uniquely identifies DR. KATHY S CLARK (MD) in U.S. healthcare data.
Does the public listing show DR. KATHY S CLARK (MD) as active?
DR. KATHY S CLARK (MD)'s NPI record reflects an active status in NPPES.
Which specialty label fits DR. KATHY S CLARK (MD)?
NPPES ties DR. KATHY S CLARK (MD) to Diagnostic Radiology Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to DR. KATHY S CLARK (MD)?
DR. KATHY S CLARK (MD) shows a connection to Indianapolis, Indiana in registry-derived data.
Why is information missing for DR. KATHY S CLARK (MD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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