GINA CLARK (NPI# 1174912406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174912406 |
| Entity Type | Individual |
| Full Name | GINA CLARK |
| Credential | APRN |
| Practice Address |
4200 Gardiner View Ave Louisville KY 40213-1877 |
| Mailing Address |
3120 Runnymede Rd Louisville KY 40222-6144 |
| Practice Telephone | 5024560494 |
| Practice Fax Number | 5024560496 |
| Mailing Telephone | 5026571076 |
| Mailing Fax Number | 8889592460 |
| Enumeration Date | 2015-01-09 |
| Last Update Date | 2019-08-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 3008878 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
3008878 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
3008878 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265985956 | Gina Maria Clark | Community Health Worker | 8212 Forest Oaks Blvd, Spring Hill, FL 34606-6839 | 2016-07-28 |
| 1871732412 | Gina Marie Clark | Social Worker | 1008 W Avenue J10, Lancaster, CA 93534-4828 | 2009-02-05 |
| 1023151784 | Gina Clark | Counselor | 800 E 6th Ave Ste B, Stillwater, OK 74074-3732 | 2007-02-14 |
| 1124101332 | Gina K Clark | Nurse Practitioner | 990 Wilkinson Trce Ste 100, Bowling Green, KY 42103-3404 | 2006-10-23 |
| 1891119996 | Gina Clark | Social Worker | 1225 E Big Beaver Rd, Troy, MI 48083-1905 | 2014-02-10 |
| 1427470558 | Gina Clark | Physical Therapist | 551 Lone Pine Blvd, The Dalles, OR 97058-9403 | 2014-01-08 |
| 1790065399 | Gina Clark | Family Medicine | 1505 E Main St, Stigler, OK 74462-2913 | 2011-08-26 |
| 1992020887 | Gina M. Clark | Student in an Organized Health Care Education/Training Program | 275 W Macarthur, Oakland, CA 94611-5641 | 2010-04-02 |
| Street Address |
4200 GARDINER VIEW AVE |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40213-1877 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114261203 | Pearl Medical Practice Pllc | Physician Assistant | 4200 Gardiner View Ave, Suite 200, Louisville, KY 40213-1877 | 2012-11-15 |
| 1316310725 | Oluwasegun A Abe | Nurse Practitioner | 4200 Gardiner View Ave, #200, Louisville, KY 40213-1877 | 2015-11-06 |
| 1407226970 | Deanna Renee Gordinier | Nurse Practitioner | 4200 Gardiner View Ave, Suite 101, Louisville, KY 40213-1877 | 2015-09-28 |
| 1669841631 | Pearl Medical Care Center | Clinical Nurse Specialist | 4200 Gardiner View Ave, Suite 101, Louisville, KY 40213-1877 | 2015-09-21 |
| 1053716803 | Kara King | Nurse Practitioner | 4200 Gardiner View Ave, Suite 101, Louisville, KY 40213-1877 | 2014-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487130076 | Latonia Cheeks | Counselor | 4835 Poplar Level Rd Ste. 110, Louisville, KY 40213 | 2018-07-17 |
| 1225553431 | Kandace Ratterman | Case Manager/Care Coordinator | 4814 Kingfisher Way, Louisville, KY 40213 | 2017-08-08 |
| 1700338456 | Ann Devos | Physician Assistant | 3303 Fern Valley Road, Louisville, KY 40213 | 2016-10-28 |
| 1124426275 | Rebecca Sue Jenkins | Home Health Aide | 3523 Whippoorwill Rd, Louisville, KY 40213 | 2014-12-05 |
| 1053518308 | Gabor Ambrus | Pathology | 4500 Conaem Drive, Louisville, KY 40213 | 2007-06-29 |
| 1760504724 | Benjamin Francis Robinson | Chiropractor | 4919h Dixie Highway, Louisville, KY 40213 | 2007-04-03 |
| 1790814408 | Howard L Green | Dentist | 3813 Poplar Level Rd, Louisville, KY 40213 | 2007-03-06 |
| 1063587970 | Roy Hyman | Optometrist | 5202 Preston Hwy, Louisville, KY 40213 | 2006-11-24 |
| 1689769291 | James H Kidwell | Psychologist | 1448 Gardiner Lane, Suite 202 203, Louisville, KY 40213 | 2006-10-03 |
| 1366556524 | Harris & Harris Dmd Psc | Dentist | 5014 Preston Hwy, #b, Louisville, KY 40213 | 2006-08-17 |
| Find all providers in zip 40213 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891393864 | Lindsay Ann Traeger | Nurse Practitioner | 633 E Main St Unit 553, Louisville, KY 40202-4739 | 2020-10-13 |
| 1669974119 | Donald Ray Avery Jr. | Nurse Practitioner | 801 Barret Ave Ste 314, Louisville, KY 40204-1734 | 2018-03-01 |
| 1730417593 | Tam Healthcare Options, Pllc. | Nurse Practitioner | 1904 Crums Ln, Louisville, KY 40216-4228 | 2009-12-05 |
| 1659991313 | Jason Pratt | Nurse Practitioner | 3975 7th Street Rd, Louisville, KY 40216-4103 | 2020-04-23 |
| 1053977041 | Enm Wellness & More | Nurse Practitioner | 801 W Broadway Ste 4, Louisville, KY 40202-2236 | 2019-05-15 |
| 1497218507 | Interlocking Hearts Healthcare - Primary and Express Care | Nurse Practitioner | 801 W Broadway Ste 4, Louisville, KY 40202-2236 | 2019-04-08 |
| 1679012256 | Katherine Voss | Nurse Practitioner | 800 Zorn Ave, Louisville, KY 40206 | 2017-02-16 |
| 1598211146 | Alternative Health Solutions LLC | Nurse Practitioner | 7098 Distribution Dr, Louisville, KY 40258-2879 | 2016-09-01 |
| 1124471883 | Kasey Ann Metts | Nurse Practitioner | 400 S 6th St, Louisville, KY 40202-2306 | 2016-07-18 |
| 1205284726 | Serena K Nevitt | Nurse Practitioner | 200 E Chestnut St Ste 303, Louisville, KY 40202-1831 | 2016-05-25 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40213 |
Please comment or provide details below to improve the information on GINA 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.