Clark Physician Group LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CLARK PHYSICIAN GROUP LLC

Practice address

1806 E 10TH St
Jeffersonville, IN 47130-6016

Phone

(812) 285-5983

Fax

(812) 280-5723

NPI assigned

Jul 31, 2008

Organization subpart

Yes

Parent organization

CLARK MEMORIAL HOSPITALAs reported in NPPES

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

Authorized official

Name

Mr. Kirk William Strack

Title

Cfo

Phone

(812) 283-2488

Specialties & licenses 11

Addresses

Other identifiers 1

Part of

Clark County Memorial Hos

Locations

Practitioners 3

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

• Laura S Hall, RD, CDE

  • Registered Dietitian
  • Jeffersonville, IN
  • NPI 1336455393
  NPD (past)
• Anna J Smith, RD, LD, CDE

  • Registered Dietitian
  • Jeffersonville, IN
  • NPI 1801102876
  NPD (past)
• Samantha Voss, LCSW

  • Clinical Social Worker
  • Jeffersonville, IN
  • NPI 1043107659
  NPD (past)

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364169600000",
    "number": "1396901104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 E 10TH ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471306016",
            "telephone_number": "812-285-5983",
            "fax_number": "812-280-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 E 10TH ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471306016",
            "telephone_number": "812-285-5983",
            "fax_number": "812-280-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK PHYSICIAN GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLARK MEMORIAL HOSPITAL",
        "enumeration_date": "2008-07-31",
        "last_updated": "2013-03-25",
        "status": "A",
        "authorized_official_last_name": "STRACK",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "812-283-2488",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100074370",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clark County Auditor
• Clark County Medical Transport LLC
• Clark Memorial Hospital
• Clark Memorial Hospital
• Clark Memorial Hospital
• Bonnie Lou Clark, PMHNP-BC
• Emily Marie Clark, PT,DPT
• Lisa Clark
• Nancy Elizabeth Clark
• May Clawson

• Family Medicine Physician in Jeffersonville, IN
• Providers in Jeffersonville, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; 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.