KELLEY D. CLARK (MD) – Maternal & Fetal Medicine Physician, NPI 1073695045
Maternal & Fetal Medicine Physician
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NPPES metrics only — not quality of care.
1,165 OBSTETRICS/GYNECOLOGY in VA
Provider Addresses for KELLEY D. CLARK (MD)
1300 Hospital Drive
Fredericksburg, VA 22401
Phone: (540) 741-3260
Fax: (859) 260-6649
Type: Location
450 S Washington St Ste D
Gettysburg, PA 173252500
Phone: (717) 338-3292
Fax: (717) 851-3127
Type: Location
22 St Paul Dr Ste 101
Chambersburg, PA 172011036
Phone: (877) 722-1757
Fax: (717) 262-2390
Type: Location
175 Martin Ave Ste 105
Ephrata, PA 175221761
Phone: (866) 244-3492
Fax: (717) 859-5637
Type: Location
1101 Edgar St Ste E
York, PA 174032862
Phone: (717) 812-4602
Fax: (717) 812-3499
Type: Location
1001 S George St
York, PA 174033676
Phone: (717) 851-2722
Fax: (717) 851-3127
Type: Location
845 Helen Dr Ste 200
Lebanon, PA 170427493
Phone: (866) 244-3492
Fax: (717) 859-5637
Type: Location
3421, Concord Road, Spring Plains, Springettsbury Township, York County, Pennsylvania, 17402, United States
YORK, PA 174029001
Phone: (717) 851-1405
Fax: (717) 851-6969
Type: Mailing
202, Monument Road, Chanticleer, York Township, York County, Pennsylvania, 17403, United States
YORK, PA 174035074
Phone: (717) 851-2722
Fax: (717) 851-3127
Type: Location
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: 2020-05-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20160120002613 | I | Obstetrics/Gynecology | VA | TBD |
| I20200504000664 | I | Obstetrics/Gynecology | PA | 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 22401)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | PA | |
| - | PA | |
| - | PA | |
| N E U R O L O G Y | SC | |
| Physician Assistant | PA | |
| Hospitalist, Internal Medicine | PA | |
| Certified Registered Nurse Anesthetist (Crna) | PA | |
| Physician Assistant | PA | |
| Family Practice | PA | |
| Internal Medicine, Pulmonary Disease, Sleep Medicine | PA |
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