Active NPI
Ryan Patrick Clark
- Case Manager/Care Coordinator
- West Lafayette, IN
National Provider Identifier
1124986757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 3000 Kent Ave
West Lafayette, IN 47906-1184 - Phone
- (866) 672-4764
- NPI assigned
- Jan 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | IN | Primary |
Addresses
Primary practice location
3000 Kent Ave
West Lafayette, IN 47906-1184
Mailing address
3000 Kent Ave
West Lafayette, IN 47906-1184
Phone (866) 672-4764
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1768262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768262400000",
"number": "1124986757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 KENT AVE",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479061184",
"telephone_number": "866-672-4764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 KENT AVE",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479061184",
"telephone_number": "866-672-4764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "RYAN",
"middle_name": "PATRICK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-01-13",
"last_updated": "2026-01-13",
"certification_date": "2026-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "IN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.