Jeanne E A Clark (NPI# 1013122852, PAC ID# 2769396662) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1013122852 |
| PAC ID by PECOS | 2769396662 |
| Professional Enrollment ID | I20070625000575 |
| Full Name | Jeanne E A Clark |
| Organization Legal Name | CLEANSLATE MEDICAL GROUP OF INDIANA LLC |
| Address |
502 W 2nd St Suite A Bloomington IN 47403-2316 |
| Phone Number | 8126681946 |
| Gender | F |
| Credential | NP |
| Graduation Year | 2002 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 4880963909 |
| Number of Group Practice Members | 51 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 502 W 2nd St, Suite A, Bloomington, IN 47403-2316 | 8126681946 | CLEANSLATE MEDICAL GROUP OF INDIANA LLC |
| Organization Legal Name | CLEANSLATE MEDICAL GROUP OF INDIANA LLC |
| Physicians | 47 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melissa G Collier | Pediatric Medicine | Cleanslate Medical Group of Indiana LLC | 65 Airport Pkwy, Suite 114, Greenwood, IN 46143-1439 |
| Kathy Ann Ehler | Nurse Practitioner | Cleanslate Medical Group of Indiana LLC | 3728 S Reed Rd, Kokomo, IN 46902-3829 |
| Nora C Wilcox | Nurse Practitioner | Cleanslate Medical Group of Indiana LLC | 1725 N Meridian St, Indianapolis, IN 46202-1403 |
| Alison Arnold | Nurse Practitioner | Cleanslate Medical Group of Indiana LLC | 101 N Harrison St, Alexandria, IN 46001-2017 |
| Kumpol Dennison | General Surgery | Cleanslate Medical Group of Indiana LLC | 3005 E State Blvd, Cleanslate Medical Group of Indiana, Fort Wayne, IN 46805-4736 |
| Jessica R Bleyle | Nurse Practitioner | Cleanslate Medical Group of Indiana LLC | 4925 S Scatterfield Rd, Cleanslate Medical Group of Indiana, Anderson, IN 46013-2911 |
| Kalee M Dunkle | Nurse Practitioner | Cleanslate Medical Group of Indiana LLC | 30 Professional Ct, Suite 2, Lafayette, IN 47905-5129 |
| Donna C Robinson | Nurse Practitioner | Cleanslate Medical Group of Indiana LLC | 811 Northgate Blvd, New Albany, IN 47150-6419 |
| Ashley L Grumbine | Nurse Practitioner | Cleanslate Medical Group of Indiana LLC | 8645 Connecticut St, Merrillville, IN 46410-6222 |
| Jack R Lowe | Nurse Practitioner | Cleanslate Medical Group of Indiana LLC | 2455 E Main St, Suite 194, Plainfield, IN 46168-2715 |
| Street Address |
502 W 2ND ST SUITE A |
| City | BLOOMINGTON |
| State | IN |
| Zip | 47403-2316 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tara A Mendoza | Nurse Practitioner | Cleanslate Medical Group of Indiana LLC | 502 W 2nd St, Suite A, Bloomington, IN 47403-2316 |
| Charles W Calhoun | Family Medicine | 502 W 2nd St, Seymour, IN 47274-2152 | |
| Bridget Ranae Stillions | Nurse Practitioner | Cleanslate Medical Group of Indiana LLC | 502 W 2nd St, Suite A, Bloomington, IN 47403-2316 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Peggy A Ryan | Nurse Practitioner | Planned Parenthood of Indiana and Kentucky Inc | 421 S College Ave, Bloomington Health Center, Bloomington, IN 47403-1514 |
| Lloyd D Ericson | Chiropractic | Osmon Chiropractic Center, LLC | 1332 W Arch Haven Ave, Suite C, Bloomington, IN 47403-2078 |
| Dylan C Witthoft | Chiropractic | Osmon Chiropractic Center, LLC | 1332 W Arch Haven Ave, Suite C, Bloomington, IN 47403-2078 |
| Brandon M Osmon | Chiropractic | Osmon Chiropractic Center, LLC | 1332 W Arch Haven Ave, Suite C, Bloomington, IN 47403-2078 |
| Beth Estelle Pruett | Chiropractic | Osmon Chiropractic Center, LLC | 1332 W Arch Haven Ave, Suite C, Bloomington, IN 47403-2078 |
| Brandon James Maze | Chiropractic | Osmon Chiropractic Center, LLC | 1332 W Arch Haven Ave, Suite C, Bloomington, IN 47403-2078 |
| Mandice M Williams | Chiropractic | Osmon Chiropractic Center, LLC | 1332 W Arch Haven Ave, C, Bloomington, IN 47403-2078 |
| David Savage | Thoracic Surgery | Indiana University Health Southern Indiana Physicians, Inc | 1312 W Arch Haven Ave A, Indiana University Health Southern, Bloomington, IN 47403-2088 |
| Thomas R Spevak | Physical Therapy | Advanced Physical Therapy LLC | 1312 W Arch Haven Ave Bldg 1320 E, Ati Physical Therapy of Indiana, Bloomington, IN 47403-2088 |
| Elysia C Tieman | Physical Therapy | Advanced Physical Therapy LLC | 1312 W Arch Haven Ave Bldg 1320 E, Ati Physical Therapy of Indiana, Bloomington, IN 47403-2088 |
| Find all physicians in zip 47403 | |||
| City | BLOOMINGTON |
| Zip Code | 47403 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | BLOOMINGTON + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.