Active NPI
Nicholas Alexander Clough, MD
- Internal Medicine Physician
- Evansville, IN
National Provider Identifier
1639828635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 01100194A
- Practice address
- 3700 Washington Ave
Evansville, IN 47714-0541 - Phone
- (812) 485-4000
- NPI assigned
- Mar 18, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01100194A | IN | Primary |
Addresses
Primary practice location
3700 Washington Ave
Evansville, IN 47714-0541
Mailing address
801 Saint Marys Dr Ste 510
Evansville, IN 47714-0511
Phone (812) 485-4423
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11022270A | Other | IN | POST-GRADUATE TRAINING PERMIT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220613002569 | IN | Order and Referring Only - Internal Medicine | 8628457124 |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Indiana Medical College, School of Medicine of Purdue University, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2100 Powell St
Emeryville, CA 94608-1826
2100 Powell St
Suite 400
Emeryville, CA 94608-1872
250 W 96TH St
Suite 520
Indianapolis, IN 46260-1317
801 Saint Marys Dr
Evansville, IN 47714-0511
Hospital & facility affiliations
- Ascension St Vincent Evansville
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- nclough206453@direct.deaconess.com
- nicholas.clough.1@7598.direct.athenahealth.com
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Evansville, IN
- NPI 1427082957
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1639828635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 SAINT MARYS DR STE 510",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477140511",
"telephone_number": "812-485-4423",
"fax_number": "812-485-7222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 WASHINGTON AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477140541",
"telephone_number": "812-485-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLOUGH",
"first_name": "NICHOLAS",
"middle_name": "ALEXANDER",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-18",
"last_updated": "2026-07-13",
"certification_date": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01100194A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "POST-GRADUATE TRAINING PERMIT",
"identifier": "11022270A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.