Jessica Ann Clark

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

37002222A Issued in IN

Practice address

6085 Heartland Dr Ste 204
Zionsville, IN 46077-4433

Phone

(317) 873-1200

Fax

(317) 873-1209

NPI assigned

May 27, 2021

Last updated

Jun 9, 2021By 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 names 1

• Jessica Ann Flenar Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1740856095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 N LEBANON ST STE 305",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460528622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6085 HEARTLAND DR STE 204",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460774433",
            "telephone_number": "317-873-1200",
            "fax_number": "317-873-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IN",
            "license": "37002222A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "FLENAR",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Christensen, MS CCC-SLP
• Lindsay Christian
• Christopher C Romas, D.D.S., P.C. (Romas Family Dental)
• Jacquelyn Cisneros
• Breuina Clark -Carpenter
• Michael J. Cloud, MD
• Pauline Therese Coderre, RPH
• Sarah Coleman, M.D.
• Gordon Charles Colson, MD
• Darrin Ray Combs, DMD

• Registered Dietitian in Zionsville, IN
• Providers in Zionsville, IN by specialty
• Registered Dietitian in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.