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NPI Code Detail

MEDICARE: CARRIE CLARKE M.D.

MEDICARE: CARRIE CLARKE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207LP3000XPediatric Anesthesiology Physician2005031609MO
2207LP3000XPediatric Anesthesiology Physician04-31510KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598713422
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE CLARKE M.D.
Provider Business Mailing Address
First Line : 2401 GILLHAM RD
Second Line : ATTN PROVIDER ENROLLMENT DEPT
City : KANSAS CITY
State : MO
Zip : 64108-4619
Country : US
Telephone Number : 816-701-5200
Fax Number : 816-302-9939
Provider Business Practice Location Address
First Line : 2401 GILLHAM RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64108-4619
Country : US
Telephone Number : 816-234-3000
Fax Number : 816-302-9939
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 12/11/2025

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Directions to “ CARRIE CLARKE M.D.” Practice Location

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