Individual provider Active NPI

Sarah K Clark, NP

  • Neonatal Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1053028365
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
71013129A Issued in IN
Practice address
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone
(317) 274-4779
Fax
(317) 948-9806
NPI assigned
Nov 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 28227628A IN
Critical Care Neonatal Nurse Practitioner 363LN0005X 71013129A IN
Neonatal Nurse Practitioner 363LN0000X 71013129A IN Primary

Addresses

Primary practice location

705 Riley Hospital Dr
Indianapolis, IN 46202-5109

Mailing address

PO Box 1026
Indianapolis, IN 46206-1026
Phone (317) 777-6435

Other practice location 1

2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9852

Other identifiers 1

IdentifierTypeStateIssuer
300069062MedicaidIN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sclark1@iuhealth.org
Direct Messaging Address sclark@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241008002751 IN Practitioner - Nurse Practitioner 1951832427 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28227628AINMDNeonatal Nurse Practitioner
71013129AINMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Southern Indiana Physicians, LLC CurrentSince Sep 4, 2024 Accepting new patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Sep 4, 2024 Accepting new patients
Iu Health Medical Group, LLC Past Accepting new patients
University Pediatric Associates, Inc. PastSince Nov 13, 2022 Accepting new patients

Locations

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

2651 E Discovery Pkwy
Bloomington, IN 47408
Phone (812) 353-9147

11700 N Meridian St
Carmel, IN 46032
Phone (317) 688-2000

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

575 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 944-3966

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1053028365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1026",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061026",
            "telephone_number": "317-777-6435",
            "fax_number": "317-777-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-274-4779",
            "fax_number": "317-948-9806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2651 E Discovery Pkwy",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474089059",
            "country_code": "US",
            "telephone_number": "812-353-9852",
            "fax_number": "812-353-9278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SARAH",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-04",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "IN",
            "license": "28227628A",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "IN",
            "license": "71013129A",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "IN",
            "license": "71013129A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300069062",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sclark1@iuhealth.org",
            "affiliation": "N",
            "address_1": "705 Riley Hospital Dr",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025109",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sclark@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2651 E Discovery Pkwy",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474089059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.