KELLY ANN CLARK – Family Nurse Practitioner, NPI 1164062972
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,017 NURSE PRACTITIONER in MO
Provider Addresses for KELLY ANN CLARK
3202 MILLER ST
BETHANY, MO 644242713
Phone: (660) 425-3154
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 39 Open Payments records for all available years, with a total value of $708.
Total Amount is formed as General ($708) + Research ($0) + Ownership ($0) = $708.
Last reported payment date: 2024-11-12 • Largest payer in this snapshot: ABBVIE INC. ($176).
Total Amount
$708
General + Research + Ownership
Payments
39
Total payment records
General Amount
$708
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $176 |
| Novo Nordisk Inc | $89 |
| AstraZeneca Pharmaceuticals LP | $70 |
| Lilly USA, LLC | $49 |
| HARMONY BIOSCIENCES LLC | $35 |
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: 2020-03-09
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200309000271 | I | Nurse Practitioner | MO | TBD |
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.
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 64424)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | NM | |
| Nurse Practitioner | MO | |
| Family Practice | MO | |
| Clinical Social Worker | MO | |
| Emergency Medicine | TX | |
| Physician Assistant | MO | |
| Emergency Medicine | OK | |
| Hospitalist, Internal Medicine | FL | |
| Family Practice | MO | |
| - | MO |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.