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

Kenneth Bryan Clark, PA

Individual provider Physician Assistant · NPI 1417903287

Kenneth Bryan Clark, PA is a Physician Assistant in Salisbury, North Carolina. Qualified in 2000, 26 years ago. Practices with Novant Health Medical Group, LLC, a 2,410-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
26
Licensed in
NC
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

810 Mitchell Ave
Salisbury, NC 28144-6253
Phone: (704) 603-1403
Fax: (704) 603-1517
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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 103056 (NC)

Record details

NPI number1417903287
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 25, 2006
Last updated in NPPESSeptember 11, 2023
Certification dateSeptember 11, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Novant Health Medical Group, Llc — 2410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations8 on file with Medicare

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