Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kendall R. Clark, MD

Individual provider Emergency Medicine Physician · NPI 1568509685

Kendall R. Clark, MD is a Family Practice in Cary, North Carolina. Qualified in 1992, 34 years ago. Practices with Aspirus Riverview Hospital and Clinics Inc, a 166-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Florida, North Carolina and Ohio.

Years since qualifying
34
Licensed in
FL, NC, OH
In the registry since
2007
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

119 SW Maynard Rd Ste 150
Cary, NC 27511-4472
Phone: (919) 578-8593
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 3601 Sw 160th Ave, Miramar, FL 33027-6308 — (877) 866-7123
  • 210 S Bennett St, Southern Pines, NC 28387-5402 — (910) 695-1313

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 200200101 (NC)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 35.144519 (OH)
Family Medicine Physician Taxonomy 207Q00000X · Licence ME65017 (FL)

Record details

NPI number1568509685
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJanuary 30, 2007
Last updated in NPPESMay 13, 2025
Certification dateMay 13, 2025
Mailing address119 Sw Maynard Rd Ste 150, Cary, NC 27511-4472

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Also practisesPERIPHERAL VASCULAR DISEASE
Medical schoolOTHER
Graduated 1992 (34 years in practice)
Group practice Aspirus Riverview Hospital And Clinics Inc — 166 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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