BRANDON CLARK (NPI# 1528522083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528522083 |
| Entity Type | Individual |
| Full Name | BRANDON CLARK |
| Credential | NP |
| Practice Address |
1481 W 10th St Indianapolis IN 46202-2803 |
| Practice Telephone | 3175540000 |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2019-02-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 28167374A | IN | Nursing Service Providers |
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
28167374A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063988939 | Brandon K Clark | Case Manager/Care Coordinator | 103 4th St, Jonesboro, LA 71251-3346 | 2018-10-18 |
| 1972054393 | Brandon Clark | Counselor | 8930 Stanford Blvd, Suite M 100, Columbia, MD 21045-5805 | 2016-10-20 |
| 1932561115 | Brandon W. Clark | Social Worker | 1203 Idaho St, Lewiston, ID 83501-1940 | 2016-03-25 |
| 1871872416 | Brandon C Clark | Counselor | 500 Fairway Dr, Deerfield Beach, FL 33441-1814 | 2011-08-14 |
| 1174844138 | Brandon Clark | Orthopaedic Surgery | 107 E Oak Ave, Flagstaff, AZ 86001 | 2010-06-14 |
| 1528256955 | Brandon Clark | Counselor | 3995 Marcola Rd, Springfield, OR 97477-7948 | 2007-10-10 |
| Street Address |
1481 W 10TH ST |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46202-2803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346244258 | Mildred Sue Mcmanus | Nurse Practitioner | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2005-06-08 |
| 1174124002 | Syreeta Diane Adams | Social Worker | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2020-11-06 |
| 1083214126 | Angela Marie Whereatt | Social Worker | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2020-10-28 |
| 1679173132 | Jennifer Smith | Social Worker | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2020-10-26 |
| 1043817745 | Leah Whitmire | Music Therapist | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2020-10-06 |
| 1831705730 | Lynnette Rosa Biviano | Social Worker | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2020-09-17 |
| 1881208114 | Jessica Lee Fromm | Social Worker | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2020-09-03 |
| 1770193104 | Jordan Kirk Trively | Pharmacist | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2020-07-31 |
| 1942819263 | Vanessa Marie Street | Nurse Practitioner | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2020-07-23 |
| 1831717248 | Allissa Long | Pharmacist | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2020-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386886 | Sara Brooke Horn | Registered Nurse | 1801 N Senate Ave Ste 3300, Indianapolis, IN 46202 | 2020-11-04 |
| 1013521905 | Zachary Camden Grimes | Registered Nurse | 720 Eskenazi Avenute, Indianapolis, IN 46202 | 2020-09-08 |
| 1790314045 | Scott C Mitchell II | Student in an Organized Health Care Education/Training Program | Indiana University School of Medicine Dept of Neurosurg, 355 W. 16th St, Gh 5100, Indianapolis, IN 46202 | 2020-04-07 |
| 1053940676 | James Patrick Kelly Iv | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Dr., Ri-5837, Indianapolis, IN 46202 | 2020-04-06 |
| 1124657697 | Betsy Wilson Stevens | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Drive, Ri-5837, Indianapolis, IN 46202 | 2020-04-06 |
| 1093340580 | Brian T Edmonds | Social Worker | Sandra Eskenazi Mental Health Center, 1700 N Illinois St, Indianapolis, IN 46202 | 2020-03-05 |
| 1326683210 | Lindsay Nicole Rich | Nurse Practitioner | 1800 N Senate Ave, Indianapolis, IN 46202 | 2019-11-14 |
| 1427693670 | Ronald Mcdonald House Charities of Central Indiana | Voluntary or Charitable | 435 Limestone Street, Indianaplois, IN 46202 | 2019-11-12 |
| 1790344760 | Kirsten Denise Leaberry | Student in an Organized Health Care Education/Training Program | Iu Health Neuroscience Center, Goodman Hall, 355 West 16th Street, Indianapolis, IN 46202 | 2019-06-12 |
| 1679138093 | Chris Olson Jr. | Student in an Organized Health Care Education/Training Program | 1701 N. Senate Blvd, Ag012, Indianapolis, IN 46202 | 2019-05-02 |
| Find all providers in zip 46202 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326683210 | Lindsay Nicole Rich | Nurse Practitioner | 1800 N Senate Ave, Indianapolis, IN 46202 | 2019-11-14 |
| 1780160069 | Cara Crone | Nurse Practitioner | 8402 Harcourt Rd Ste 500, Indianapolis, IN 46260-2054 | 2018-07-19 |
| 1689129645 | Casie Stevens | Nurse Practitioner | 1701 Senate Blvd Ste 238, Indianapolis, IN 46202-1239 | 2016-08-19 |
| 1548611346 | Jenna N Treadwell | Nurse Practitioner | 1801 N Senate Blvd Ste 230, Indianapolis, IN 46202-1252 | 2016-06-23 |
| 1073627865 | Connie Lynn Allen | Nurse Practitioner | 5940 Decatur Blvd, Indianapolis, IN 46241-9579 | 2006-08-18 |
| 1881209294 | Jennifer L Maupin | Nurse Practitioner | 2001 W 86th St, Indianapolis, IN 46260-1902 | 2020-09-11 |
| 1881207686 | Mary Anjanette Romer | Nurse Practitioner | 720 Eskenazi Ave, Indianapolis, IN 46202-5187 | 2020-08-31 |
| 1508475526 | Wade Everett Oliver | Nurse Practitioner | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-07-27 |
| 1538778600 | Marleana Leann Groh | Nurse Practitioner | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-07-24 |
| 1093331084 | Katherine Leigh Walker | Nurse Practitioner | 550 University Blvd Ste 6100, Indianapolis, IN 46202-5149 | 2020-06-25 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46202 |
Please comment or provide details below to improve the information on BRANDON 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.