JESSE N CLARK (NPI# 1154642585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154642585 |
| Entity Type | Individual |
| Full Name | JESSE N CLARK |
| Credential | DO |
| Practice Address |
10122 E. 10th Street Suite 100 Indianapolis IN 46229-2697 |
| Mailing Address |
6626 E 75th St Suite 500 Indianapolis IN 46250-2805 |
| Practice Telephone | 3173555717 |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2017-04-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 02004005A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201084130 | 05 | |
| IN | RR MEDICARE | P01424293 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730517087 | Jesse Wayne Clark | Counselor | 65 Grady Ct, Dayton, OH 45409 | 2013-10-24 |
| 1699323931 | Jesse Clark | Occupational Therapy Assistant | 3485 Windsor Ave, Dubuque, IA 52001-1329 | 2019-08-29 |
| 1043721129 | Jesse Kay Clark | Physician Assistant | 800 5th Ave Ste 300, Fort Worth, TX 76104-7303 | 2017-10-17 |
| 1811166572 | Jesse Lawton Clark | Internal Medicine | 5767 W Century Blvd, Suite 200, Los Angeles, CA 90045-5632 | 2008-02-27 |
| 1376729756 | Jesse D Clark | Dentist | 1611 Greenfield St, Wilmington, NC 28401-6455 | 2008-01-15 |
| Street Address |
10122 E. 10TH STREET SUITE 100 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46229-2697 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912971029 | Aria Arrizabalaga | Specialist | 10122 E. 10th Street, Suite 100, Indianapolis, IN 46229-2697 | 2006-02-15 |
| 1164656013 | Casandra Miller Cashman | Family Medicine | 10122 E. 10th Street, Suite 100, Indianapolis, IN 46229-2697 | 2009-05-06 |
| 1689697757 | Sue S Pallekonda | Family Medicine | 10122 E. 10th Street, Suite 100, Indianapolis, IN 46229-2697 | 2006-07-26 |
| 1316971963 | Stephanie Suzanne Nader | Social Worker | 10122 E. 10th Street, Suite 100, Indianapolis, IN 46229-2697 | 2006-07-10 |
| 1942233358 | Karl Leo Ost | Emergency Medicine | 10122 E. 10th Street, Suite 100, Indianapolis, IN 46229-2697 | 2006-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487150124 | Patrice R. Mosley | Registered Nurse | 9385 E Washington St, Indianapolis, IN 46229 | 2018-04-02 |
| 1013424621 | Latasha Fisher | Registered Nurse | 9822 Fulbrook Dr, Indianapolis, IN 46229 | 2018-01-04 |
| 1417324856 | Ourhealth Physicians Group, LLC | Clinic/Center | 9934 E Washington Street, Indianapolis, IN 46229 | 2015-09-01 |
| 1134479470 | Loving Hands Senior Care and Relocation | In Home Supportive Care | 9702 E Washington Ste 400 Pmd 185, Indianapolis, IN 46229 | 2012-09-13 |
| 1902155815 | Planned Parenthood of Indiana Eastside | Clinic/Center | 9385 E. Washington St., Indianapolis, IN 46229 | 2012-09-06 |
| 1407092497 | Amy Katherine Graham | Chiropractor | 11020 E 10th St Ste B, Indianapolis, IN 46229 | 2008-12-23 |
| 1043408610 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 9630 Washington Street, Indianapolis, IN 46229 | 2007-10-09 |
| 1487867024 | Holli A H Bowser | Dietitian, Registered | 9660 E Washington St, Indianapolis, IN 46229 | 2007-05-08 |
| 1336361708 | Dental Professionals of Indiana, P.C. | Dentist | 986 North Mitthoeffer, Indianapolis, IN 46229 | 2007-05-03 |
| 1386865558 | Gary Lee Bacon | Dentist | 316 Washington Pointe Drive, Indianapolis, IN 46229 | 2007-05-02 |
| Find all providers in zip 46229 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073125225 | Relymd Medical Group In, LLC | Family Medicine | 9221 Crawfordsville Rd, Indianapolis, IN 46234-1521 | 2020-08-19 |
| 1134765993 | Basil Vareldzis | Family Medicine | 9125 Nautical Watch Dr, Indianapolis, IN 46236-9036 | 2019-11-26 |
| 1366084329 | Rebekah Venable | Family Medicine | 5455 W 86th St Ste 210, Indianapolis, IN 46268-1530 | 2019-10-11 |
| 1710455738 | Physicians Wellness Associates LLC | Family Medicine | 4735 Statesmen Drive, Suite C, Indianapolis, IN 46250 | 2018-11-07 |
| 1386150043 | Brengle Family Medicine | Family Medicine | 8803 N Meridian St Ste 350, Indianapolis, IN 46260-5386 | 2017-12-18 |
| 1164937249 | Amy Cheung | Family Medicine | 6484 N Chester Ave, Indianapolis, IN 46220-4422 | 2017-12-11 |
| 1578017182 | Medical Specialty LLC | Family Medicine | 2301 N Meridian St, Indianapolis, IN 46208-5729 | 2016-08-11 |
| 1245685742 | Christopher Basom | Family Medicine | 8501 E 56th St Ste 120, Indianapolis, IN 46216-2118 | 2016-05-03 |
| 1760846877 | Catherine Gambale Trigonis | Family Medicine | 404 E Washington St Ste A, Indianapolis, IN 46204 | 2016-04-06 |
| 1205204203 | Community Health Network | Family Medicine | 1643 E Hanna Ave, Ste 108, Indianapolis, IN 46227-3655 | 2015-09-08 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46229 |
Please comment or provide details below to improve the information on JESSE N 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.