North Clark Medical Group LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

NORTH CLARK MEDICAL GROUP LLC

Practice address

1802 E 10TH St
Jeffersonville, IN 47130-6016

Phone

(812) 288-2488

Fax

(812) 288-6603

NPI assigned

Nov 2, 2016

Last updated

Apr 9, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Suhas Gandhi

Title

Authorized Official

Phone

(502) 244-9859

Specialties & licenses 15

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IN, KY, TX, GA5 enrollments

Opioid treatment program

Medicare-enrolled since Aug 7, 2024

Enrollment records 5

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 65

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carolyn R Fegenbush, ARNP

  • Nurse Practitioner
  • Jeffersonville, IN
  • NPI 1629009790

  Addiction Medicine, KY

  Medicare reassignment Care Compare group NPD
• Darin A Harden, MD

  • Internal Medicine Physician
  • Jeffersonville, IN
  • NPI 1194702381

  Addiction Medicine, KY

  Medicare reassignment Care Compare group NPD
• Syed Q Kazmi, M.D.

  • Internal Medicine Physician
  • Jeffersonville, IN
  • NPI 1487619888

  KY

  Medicare reassignment Care Compare group NPD
• Amy Marie Martin, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jeffersonville, IN
  • NPI 1770130122

  KY

  Medicare reassignment Care Compare group NPD
• Sanjay N Patel, DC

  • Chiropractor
  • Jeffersonville, IN
  • NPI 1467404772

  Addiction Medicine, KY

  Medicare reassignment Care Compare group NPD
• Zaka U Rahman, MD

  • Cardiovascular Disease Physician
  • Jeffersonville, IN
  • NPI 1376531194

  KY

  Medicare reassignment Care Compare group NPD
• Kochurani Jacob Thomas, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Clarksville, IN
  • NPI 1699315531

  KY

  Medicare reassignment Care Compare group NPD
• Denise Blair Wilburn

  • Family Nurse Practitioner
  • Jeffersonville, IN
  • NPI 1417984758

  Addiction Medicine, KY

  Medicare reassignment Care Compare group NPD
• Holly A Woosley, APRN, MSN, FNP-C

  • Family Nurse Practitioner
  • Charlestown, IN
  • NPI 1568087625

  KY

  Medicare reassignment Care Compare group NPD
• Angela Opal Allen, APRN

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1740882117

  IN

  Medicare reassignment Care Compare group NPD
• Erwin Banzon

  • Certified Registered Nurse Anesthetist
  • Louisville, KY
  • NPI 1134588627

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Mariano A Galang III, M.D.

  • Psychiatry Physician
  • Louisville, KY
  • NPI 1346283603
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775692800000",
    "number": "1376095711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MARKET ST STE 101",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471119535",
            "telephone_number": "812-503-5100",
            "fax_number": "770-573-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 E 10TH ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471306016",
            "telephone_number": "812-288-2488",
            "fax_number": "812-288-6603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 Short St",
            "address_purpose": "LOCATION",
            "city": "Charlestown",
            "state": "IN",
            "postal_code": "471111241",
            "country_code": "US",
            "telephone_number": "812-503-5100",
            "fax_number": "812-288-6603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1804 E 10th St",
            "address_purpose": "LOCATION",
            "city": "Jeffersonville",
            "state": "IN",
            "postal_code": "471306016",
            "country_code": "US",
            "telephone_number": "812-288-2488",
            "fax_number": "812-288-6603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 E Jefferson St",
            "address_purpose": "LOCATION",
            "city": "LA Grange",
            "state": "KY",
            "postal_code": "400311445",
            "country_code": "US",
            "telephone_number": "502-233-3290",
            "fax_number": "812-288-6603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1806 E 10th St",
            "address_purpose": "LOCATION",
            "city": "Jeffersonville",
            "state": "IN",
            "postal_code": "471306478",
            "country_code": "US",
            "telephone_number": "812-288-2488",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1211 W Broadway Ste A",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402032082",
            "country_code": "US",
            "telephone_number": "502-233-3290",
            "fax_number": "502-470-5915",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "645 S Roy Wilkins Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402032072",
            "country_code": "US",
            "telephone_number": "812-288-2488",
            "fax_number": "812-288-6603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTH CLARK MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-02",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A",
        "authorized_official_last_name": "GANDHI",
        "authorized_official_first_name": "SUHAS",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "502-244-9859"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100535740",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE IN",
            "identifier": "IN3604",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE KY",
            "identifier": "K258180",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300010664",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Virginia L Nisbet, NP-C
• Minette Nkwanwo
• Robert Matthew Nolan, D.C.
• Jamier Norfleet
• Alyssa Norman
• North Clark Urgent Care LLC
• Maricathryn Northam, LCSW
• Norton Clark Hospital, LLC (Norton Clark Hospital)
• Norton Clark Hospital, LLC
• Norton Clark Physician Practices, LLC (Clark Memorial Clinic Connection)

• General Practice Physician in Jeffersonville, IN
• Providers in Jeffersonville, IN by specialty
• General Practice Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.