GREGORY S CLARK (NPI# 1164841102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164841102 |
Entity Type | Individual |
Full Name | GREGORY S CLARK |
Credential | PA-C |
Practice Address |
8433 Harcourt Rd Ste 100 Indianapolis IN 46260-2193 |
Mailing Address |
10330 N Meridian St # 300 Indianapolis IN 46290-1024 |
Practice Telephone | 3175837600 |
Enumeration Date | 2014-04-07 |
Last Update Date | 2017-01-03 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
10000165A | IN | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760991012 | Gregory Clark | Driver | 1091 Old South Dr, Lakeland, FL 33811 | 2017-09-28 |
1184758229 | Gregory Ray Clark | Physical Therapist | 3 Windsor Ct, Shawnee, OK 74804-2330 | 2007-03-14 |
1114064797 | Gregory Dale Clark | Dentist | 4212 Mcever Rd, Oakwood, GA 30566-2237 | 2007-01-31 |
1225141823 | Gregory Lynn Clark | Specialist | 11790 Sw Barnes Rd, Suite 330, Portland, OR 97225-5934 | 2006-08-16 |
1689608952 | Gregory D Clark | Social Worker | 118 Broadway N, Ste 810, Fargo, ND 58102-4949 | 2006-07-10 |
1164409728 | Gregory Clark | Counselor | 225 N Beaumont Rd, Prairie Du Chien, WI 53821-1445 | 2005-12-26 |
1528627833 | Gregory Scott Clark | Nurse Anesthetist, Certified Registered | 3333 W Deyoung St, Marion, IL 62959-5884 | 2019-06-10 |
1073178851 | Gregory Clark | Student in an Organized Health Care Education/Training Program | 550 1st Ave, New York, NY 10016-6402 | 2019-05-07 |
1548736622 | Gregory Allen Clark | Marriage & Family Therapist | 1150 5th St Ste 270, Coralville, IA 52241-2933 | 2018-10-16 |
1881055911 | Gregory Scott Clark Jr. | Counselor | 1121 E Southeast Loop 323 Ste 204, Tyler, TX 75701 | 2016-03-17 |
Street Address |
8433 HARCOURT RD STE 100 |
City | INDIANAPOLIS |
State | IN |
Zip Code | 46260-2193 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235138504 | Gregory C Yerington | Anesthesiology | 8433 Harcourt Rd Ste 100, Indianapolis, IN 46260-2193 | 2005-07-19 |
1386251189 | Nicole Dianne Frick | Physician Assistant | 8433 Harcourt Rd Ste 100, Indianapolis, IN 46260-2193 | 2020-09-25 |
1821612391 | Sophie Elizabeth Brown | Physician Assistant | 8433 Harcourt Rd Ste 100, Indianapolis, IN 46260-2193 | 2020-06-01 |
1942823604 | Sara Monhollen | Physician Assistant | 8433 Harcourt Rd Ste 100, Indianapolis, IN 46260-2193 | 2020-05-28 |
1275989931 | Sarah Jo Graham | Nurse Practitioner | 8433 Harcourt Rd Ste 100, Indianapolis, IN 46260 | 2016-05-11 |
1578944427 | Sarah Strot | Surgery | 8433 Harcourt Rd Ste 100, Indianapolis, IN 46260-2193 | 2015-06-17 |
1023416872 | Davina Ananias | Physician Assistant | 8433 Harcourt Rd Ste 100, Indianapolis, IN 46260-2193 | 2014-12-10 |
1598193807 | Emily Elizabeth Shumaker | Physician Assistant | 8433 Harcourt Rd Ste 100, Indianapolis, IN 46260-2193 | 2013-10-23 |
1285066472 | Nathan Joseph Woebkenberg | Physician Assistant | 8433 Harcourt Rd Ste 100, Indianapolis, IN 46260-2193 | 2013-07-30 |
1972945194 | Michelle Rene Lashorne | Nurse Practitioner | 8433 Harcourt Rd Ste 100, Indianapolis, IN 46260 | 2013-07-30 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508478298 | Verity Smile Studio, LLC | Clinic/Center | 1619 W. 86th St Suite B, Indianapolis, IN 46260 | 2020-08-23 |
1225666589 | Alexander Michael Kiel | Student in an Organized Health Care Education/Training Program | Internal Medicine 3 North, 2001 W. 86th Street, Indianapolis, IN 46260 | 2020-03-31 |
1043793151 | Lisa R Foreman | Registered Nurse | 1389 W. 86th Street Unit # 238, Indianapolis, IN 46260 | 2018-09-13 |
1790268399 | Esther Muturi | Chore Provider | 1214 Racquetclub South Drive Apt C, Indianapolis, IN 46260 | 2018-09-10 |
1912483215 | Katherine Donnelly | Community Health Worker | 1612 Lancashire Ct, Indianapolis, IN 46260 | 2018-07-19 |
1326539628 | Peaceful Source Midwifery LLC | Advanced Practice Midwife | 1139 Canterbury Ct., Unit B, Indianapolis, IN 46260 | 2018-05-22 |
1144722695 | Mindful Services Center LLC | Clinic/Center | 9002 N Meridian St, Ste 200, Indianapolis, IN 46260 | 2018-03-01 |
1144731910 | Meenu Jain | Student in an Organized Health Care Education/Training Program | Internal Medicine, 8414 Naab Road, Suite 100, Indianapolis, IN 46260 | 2017-10-19 |
1609392422 | 1717 Senior Living, LLC | Assisted Living Facility | 1703 West 86th Street, Indianapolis, IN 46260 | 2017-08-15 |
1093246985 | Royalty Transports LLC | Bus | 2255 W. 67th St., Indianapolis, IN 46260 | 2017-03-23 |
Find all providers in zip 46260 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760947329 | Ellen M Randall | Physician Assistant | 705 Riley Hospital Dr Ste 2514, Indianapolis, IN 46202-5109 | 2019-02-07 |
1255685772 | Jarron J Lincoln | Physician Assistant | 5230 E Stop 11 Rd Ste 250, Indianapolis, IN 46237 | 2012-11-06 |
1912963620 | Kimberly D Hand | Physician Assistant | 8141 South Emerson Ave, Suite A, Indianapolis, IN 46237 | 2006-04-21 |
1447212162 | Jennifer S. Rothenberger | Physician Assistant | 8333 Naab Rd Ste 250, Indianapolis, IN 46260 | 2006-04-06 |
1235129909 | Megan Lynn Chojnacki | Physician Assistant | 8501 Harcourt Rd, Indianapolis, IN 46260-2046 | 2005-10-25 |
1922005289 | Angela Kaye Unfried | Physician Assistant | 8075 N Shadeland Ave, Suite 120, Indianapolis, IN 46250-2693 | 2005-07-01 |
1407495906 | Rachel C Ehrman | Physician Assistant | 7250 Clearvista Dr Ste 100, Indianapolis, IN 46256-4640 | 2019-12-31 |
1922659226 | Taylor Ann Smith | Physician Assistant | 2001 W 86th St, Indianapolis, IN 46260-1902 | 2019-09-27 |
1790261576 | Kristiana Michelle Sannella | Physician Assistant | 10590 N Meridian St # 105, Indianapolis, IN 46290 | 2018-07-16 |
1093201048 | Brooke Michele Stein | Physician Assistant | 10590 N Meridian St Ste 105, Indianapolis, IN 46290-1028 | 2018-07-02 |
Find all providers in INDIANAPOLIS |
City | INDIANAPOLIS |
Zip Code | 46260 |
Please comment or provide details below to improve the information on GREGORY S CLARK.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.