Gabrielle L Clark, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22006568A Issued in IN

Practice address

1185 W Carmel Dr Ste D1A
Carmel, IN 46032-8708

Phone

(317) 450-4180

Fax

(317) 324-3950

NPI assigned

Jan 19, 2020

Last updated

Sep 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Gabrielle L Ambrose Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gclark@direct.iuhealth.org

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

• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment Care Compare group NPD
• Indiana University Health Care Associates, Inc

  dba IU Health Physicians

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1902032832
  Medicare reassignment NPD
• University Otolaryngology Associates, Inc.

  • Otolaryngology Physician
  • Indianapolis, IN
  • NPI 1275563447
  Medicare reassignment NPD
• University Medical Diagnostic Associates, Inc.

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1861441537
  NPD (past)

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

{
    "created_epoch": "1579392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1568092559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 W CARMEL DR STE D1A",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328708",
            "telephone_number": "317-450-4180",
            "fax_number": "317-324-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "GABRIELLE",
        "middle_name": "L",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-19",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22006568A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PTAN",
            "identifier": "Q00139223",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "264430A72",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300034682",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "063220046",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PTAN",
            "identifier": "Q00478549",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gclark@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1185 W Carmel Dr Ste D1A",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460328708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "GABRIELLE",
            "last_name": "AMBROSE",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Clare Bridge of Carmel, LLC (Brookdale Carmel)
• Clarian North Medical Center
• Clarity & Control Counseling LLC (Clarity & Control Counseling)
• Deborah Kem Clark, MD
• Emily Clark
• Garrett Clark
• Heidi Ringgenberg Clark, MAT, CCC-SLP
• Jasmine Makayla Clark, WRAPAROUND
• Jennifer Clark, PHARM.D
• Joanne Mary Clark, OTR

• Speech-Language Pathologist in Carmel, IN
• Providers in Carmel, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.