North Clark Anesthesia Group LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

NORTH CLARK ANESTHESIA GROUP LLC

Practice address

2100 Market St Ste 200
Charlestown, IN 47111-8507

Phone

(812) 503-5100

Fax

(770) 573-9513

NPI assigned

Jul 10, 2020

Organization subpart

No

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

Authorized official

Name

Steven Smith

Title

Manager

Phone

(502) 244-9859

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pushpa Pavuluri, M.D.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1194771204
  NPD (past)

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692748800000",
    "number": "1235757709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 S CLARK BLVD # 2100",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471293212",
            "telephone_number": "502-244-9859",
            "fax_number": "770-573-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MARKET ST STE 200",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471118507",
            "telephone_number": "812-503-5100",
            "fax_number": "770-573-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CLARK ANESTHESIA GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-10",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "502-244-9859"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindful Life, LLC
• Delia Mitchell
• Burl Morris
• Sandra Morrison
• Destini Napier, LMHC
• North Clark Behavioral Health LLC
• North Clark Physicians Group LLC
• North Clark Surgery Center LLC
• William Northern Jr.
• NPF Foot and Ankle

• Anesthesiology Physician in Charlestown, IN
• Providers in Charlestown, IN by specialty
• Anesthesiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.