Kilmeny Clark
NPI 1104443258ActiveIndividual· Physician Assistant· Bloomington, IL
Physician Assistant with Carle Health Care Incorporated and 1 other group, practicing in Bloomington, Illinois. Enrolled in Medicare as practitioner - physician assistant. Lists Carle Bromenn Medical Center as a hospital affiliation.
Overview
| NPI | 1104443258 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Jul 5, 2020 |
| Last updated in NPPES | Jun 9, 2025 |
| Certified by provider | May 21, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 085.008097 | IL |
| Physician Assistant | 363A00000X | 5318-23 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (IL) |
|---|
Education and affiliations
| Graduation year | 2020 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical groups
- Carle Health Care IncorporatedUrbana, IL · 1,666 clinicians
- Carle West Physician Group IncBloomington, IL · 271 clinicians
Hospital affiliation
- Carle Bromenn Medical CenterNormal, IL
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
Other Physician Assistant providers in Bloomington
- 1225912231
- 1588653935
- 1558500579
- 1922619535
- 1639084346
- 1487172409
- 1073183844
- 1114271905
- 1326618802
- 1710797469
- 1871725515
- 1841073137