Individual provider Active NPI

Natalie Marie Clark

  • Student in an Organized Health Care Education/Training Program
  • Louisville, KY
National Provider Identifier
1669979167
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
500 S Preston St RM 305
Louisville, KY 40202-1702
Phone
(502) 852-8696
NPI assigned
Apr 11, 2018
Last updated
Apr 11, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X KY Primary

Addresses

Primary practice location

500 S Preston St RM 305
Louisville, KY 40202-1702

Mailing address

500 S Preston St RM 305
Louisville, KY 40202-1702
Phone (502) 852-8696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240909001128 FL Order and Referring Only - Gynecological OncologyPractitioner - Gynecological Oncology 6204376056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: nclark3602169@adventhealth.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1669979167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S PRESTON ST RM 305",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021702",
            "telephone_number": "502-852-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S PRESTON ST RM 305",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021702",
            "telephone_number": "502-852-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "NATALIE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.