Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly Lynne Clark, PA-C

Individual provider Physician Assistant · NPI 1215418397

Kelly Lynne Clark, PA-C is a Physician Assistant in Lexington, Kentucky. Qualified in 2018, 8 years ago. Practices with Proactive Therapy, Inc, a 122-clinician group and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
8
Licensed in
KY
In the registry since
2018
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1207 S Broadway
Lexington, KY 40504-2701
Phone: (859) 258-8261
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA3377 (KY)

Record details

NPI number1215418397
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 27, 2018
Last updated in NPPESFebruary 13, 2026
Certification dateFebruary 13, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Proactive Therapy, Inc — 122 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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