Clark Memorial Hospital

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CLARK MEMORIAL HOSPITAL

Doing business as

Primary Care Services

Practice address

1806 E 10TH St
Jeffersonville, IN 47130

Phone

(812) 285-5926

Fax

(812) 280-5723

NPI assigned

Jun 2, 2006

Last updated

Jul 31, 2008By 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

Mr. Kirk William Strack

Title

Vice President Finance Cfo

Phone

(812) 283-2488

Specialties & licenses 5

Addresses

Other identifiers 3

Other names 1

• Primary Care Services Doing business as

Locations

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1629015953",
    "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": "47130",
            "telephone_number": "812-285-5926",
            "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": "47130",
            "telephone_number": "812-285-5926",
            "fax_number": "812-280-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "STRACK",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCE 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": "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
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "CI1990",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "CD6896",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100074370",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lexi Christian
• Marlene Chua, MD
• Clark Co. Health Dept.
• Clark County Auditor (Clark County Health Department)
• Clark County Medical Transport LLC
• Clark Memorial Hospital
• Clark Memorial Hospital
• Clark Physician Group LLC
• Bonnie Lou Clark, PMHNP-BC
• Emily Marie Clark, PT,DPT

• 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 Jul 31, 2008; 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.