JORDAN LEE CLARK (NPI# 1376029223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376029223 |
| Entity Type | Individual |
| Full Name | JORDAN LEE CLARK |
| Credential | PHARMD |
| Practice Address |
3000 S State Road 135 Greenwood IN 46143-9825 |
| Mailing Address |
6576 Caressa Way Indianapolis IN 46259-1473 |
| Practice Telephone | 3175354075 |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2018-07-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P2201X |
Pharmacist Specialization: Ambulatory Care |
26027060A | IN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679508345 | Jordan Barton Clark | Speech-Language Pathologist | 1462 S 231st Ln, Buckeye, AZ 85326-6131 | 2006-07-11 |
| 1417563206 | Jordan Clark | Behavior Technician | 2312 Durwood Rd, Little Rock, AR 72207-3431 | 2020-09-17 |
| 1407461544 | Jordan Parker Clark | Case Manager/Care Coordinator | 1108 Washington St E, Lewisburg, WV 24901-2523 | 2020-09-15 |
| 1104442417 | Jordan Clark | Chiropractor | 10192 Grand River Rd Ste 107, Brighton, MI 48116-6531 | 2020-06-23 |
| 1427684646 | Jordan Clark | Behavior Technician | 418 W Mountain St Ste B, Kernersville, NC 27284-2534 | 2020-03-19 |
| 1336701911 | Jordan Joseph Clark | Physician Assistant | 8072 Normandy Dr, Fort Riley, KS 66442-7069 | 2019-07-03 |
| 1649772765 | Jordan Alexander Clark | Physical Therapist | 1380 E Medical Center Dr, St George, UT 84790-2123 | 2018-03-05 |
| 1245611623 | Jordan Clark | Dietitian, Registered | 1000 N Shenandoah Ave, Front Royal, VA 22630-3547 | 2015-06-11 |
| Street Address |
3000 S STATE ROAD 135 |
| City | GREENWOOD |
| State | IN |
| Zip Code | 46143-9825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144250689 | David K Booth II | Family Medicine | 3000 S State Road 135, Suite 310, Greenwood, IN 46143-9825 | 2006-07-03 |
| 1386259786 | Amanda Jo Pantone | Dietitian, Registered | 3000 S State Road 135, Greenwood, IN 46143-9825 | 2020-09-11 |
| 1144889486 | Jamie Marie Wallace | Physical Therapist | 3000 S State Road 135, Greenwood, IN 46143-9825 | 2019-06-11 |
| 1649786765 | Chelsea Angelo | Speech-Language Pathologist | 3000 S State Road 135, Greenwood, IN 46143-9825 | 2017-12-27 |
| 1174066856 | Andrew Keith Roark | Physical Therapist | 3000 S State Road 135, Suite 110, Greenwood, IN 46143-9825 | 2016-11-29 |
| 1982054771 | Kiersten Hunter | Speech-Language Pathologist | 3000 S State Road 135, Suite 110, Greenwood, IN 46143-9825 | 2016-06-13 |
| 1992164297 | Jacqueline Fleagle | Physical Therapist | 3000 S State Road 135, Suite 110, Greenwood, IN 46143-9825 | 2016-02-15 |
| 1114357506 | Jillian E Sullivan | Psychologist | 3000 S State Road 135, Suite 230, Greenwood, IN 46143-9607 | 2013-11-20 |
| 1629407754 | Heidi Jo Coppess | Physical Therapist | 3000 S State Road 135, Greenwood, IN 46143-9607 | 2013-11-08 |
| 1376972844 | Laura Fikes | Occupational Therapist | 3000 S State Road 135, Greenwood, IN 46143-9607 | 2013-11-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395299 | Tiffany Smirat | Pharmacist | 882 S Sr 135, Greenwood, IN 46143 | 2020-10-27 |
| 1083250138 | Benajmin Thomas Nyboer | Pharmacist | 5961 North State Road 135, Kroger Pharmacy, Greenwood, IN 46143 | 2019-11-25 |
| 1609417260 | Orthopaedics-indianapolis, Inc | Orthopaedic Surgery | 1579 Olive Branch Parke Lane, Suite 130, Greenwood, IN 46143 | 2019-10-04 |
| 1194282525 | Homebased Mental Health Service | Case Management | 2244 Blossom Dr, Greenwood, IN 46143 | 2019-02-21 |
| 1710478078 | Anne E Packard | Pharmacist | 333 E County Line Rd # 101, Greenwood, IN 46143 | 2018-05-22 |
| 1033607924 | Ez Clinic Inc. | Nurse Practitioner | 494 S Emerson Ave Ste I, Greenwood, IN 46143 | 2018-04-25 |
| 1891246633 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 5961 N Sr 135, Greenwood, IN 46143 | 2016-10-17 |
| 1477919637 | Ourhealth Physicians Group, LLC | Clinic/Center | 1273 N Emerson Ave Ste H, Greenwood, IN 46143 | 2016-01-04 |
| 1003212655 | American Health Network of Indiana, LLC | Non-Pharmacy Dispensing Site | 2355 Endress Place St A, Healthy Measures Wellness Clinic, Greenwood, IN 46143 | 2014-11-10 |
| 1265831366 | Katie D'agosto | Counselor | 3000 S State Road 135 Ste 230, Greenwood, IN 46143 | 2014-08-14 |
| Find all providers in zip 46143 | ||||
| Taxonomy Code | 1835P2201X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Ambulatory Care |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in the provision of integrated, accessible health care services by pharmacists and is accountable for addressing medication needs, developing sustained partnerships with patients, and practicing in the context of family and community. |
| Notes: Source: Board of Pharmacy Specialties, www.bpsweb.org [7/1/2015: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023618857 | Carol Chan | Pharmacist | 7905 Calumet Ave Fl 3, Munster, IN 46321-2549 | 2020-10-30 |
| 1780218693 | Charlotte Wilson | Pharmacist | 889 N Gospel St Ste 2, Paoli, IN 47454-9804 | 2020-02-29 |
| 1831745470 | Mackenzie Margaret Farrar | Pharmacist | 9650 E Washington St # 100, Indianapolis, IN 46229-3032 | 2019-08-09 |
| 1760907315 | Lisa Ann Mueller | Pharmacist | 10122 E 10th St Ste 210, Indianapolis, IN 46229-2664 | 2017-08-04 |
| 1013439090 | Lauren Kenning | Pharmacist | 1565 Saylor St, Zionsville, IN 46077-1842 | 2017-07-12 |
| 1306390505 | Kimberly Simmons | Pharmacist | 7716 Eagle Crescent Dr, Zionsville, IN 46077-4505 | 2016-08-05 |
| 1134729189 | Anna-maureen Aladejebi | Pharmacist | 4205 Commerce Dr, Lafayette, IN 47905-3800 | 2020-10-29 |
| 1013516079 | Ricky James King | Pharmacist | 1494 W Main St, Mitchell, IN 47446-9493 | 2020-10-21 |
| 1467059386 | Karen Pawlak | Pharmacist | 7502 Southtown Xing, Fort Wayne, IN 46816-2515 | 2020-10-04 |
| 1184233272 | Camala Murray I | Pharmacist | 1701 N Senate Ave # Ag401, Indianapolis, IN 46202-5306 | 2020-07-24 |
| Find all providers with the same taxonomy | ||||
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| 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.