Active NPI
Gail A Clark, CNM
- Advanced Practice Midwife
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 09000192A
- Practice address
- 8028 Carnegie Blvd Ste 300
Fort Wayne, IN 46804-5788 - Phone
- (260) 425-6650
- Fax
- (260) 755-6233
- NPI assigned
- Oct 19, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 71003121A | IN | |
| Advanced Practice Midwife | 367A00000X | 09000192A | IN | Primary |
Addresses
Primary practice location
8028 Carnegie Blvd Ste 300
Fort Wayne, IN 46804-5788
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201044030 | Medicaid | IN | |
| 815500500 | Other | IN | MEDICARE PTAN |
Electronic endpoints 5
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gclark@direct.iuhealth.org | Direct | |
| Direct Messaging Address | gclark106166@Direct.Parkviewexchange.com | ||
| FHIR URL | https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/ | ||
| FHIR URL | https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/ | ||
| Direct Messaging Address | gclark@direct.iuhealth.org | Direct |
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Nurse Midwife (CNM)
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.53 of 100
- Quality
- 70
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.11
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09000192A | IN | MD | Advanced Practice Midwife |
| 71003121A | IN | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arnett Clinic, LLC | Current | Accepting new patients | |
| Indiana University Health Ball Memorial Physicians, Inc. | Current | Accepting new patients | |
| Iu Health Medical Group, LLC | Current | Accepting new patients | |
| Arnett Clinic, LLC | Current | Accepting new patients | |
| Arnett Clinic, LLC | Current | Accepting new patients |
Locations
8016 Reliable Pkwy
Chicago, IL 60686
3832 Solutions Ctr
Chicago, IL 60677
11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
2600 Greenbush St
Lafayette, IN 47904
5165 McCarty Ln
Rm 28A
Lafayette, IN 47905
5165 McCarty Ln
Lafayette, IN 47905
Phone (800) 899-8448
2901 W Jackson St
Muncie, IN 47304
Phone (765) 286-3900
2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111
221 N Celia Ave
Muncie, IN 47303
Phone (765) 747-3141
500 W Votaw St
Portland, IN 47371
Phone (260) 726-6515
1809 S Main St
Upland, IN 46989
Phone (765) 660-7520
Interoperability endpoints
- gclark106166@direct.parkviewexchange.com
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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-
- Internal Medicine Physician
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- NPI 1164490843
-
- Family Medicine Physician
- Muncie, IN
- NPI 1235455544
-
- Family Medicine Physician
- Fort Wayne, IN
- NPI 1932130952
-
- Durable Medical Equipment & Medical Supplies
- Lafayette, IN
- NPI 1699839563
-
- Clinical Medical Laboratory
- Lafayette, IN
- NPI 1881655090
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717459200000",
"number": "1760718258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11109 PARKVIEW PLAZA DR # 117",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8028 CARNEGIE BLVD STE 300",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468045788",
"telephone_number": "260-425-6650",
"fax_number": "260-755-6233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "GAIL",
"middle_name": "A",
"credential": "CNM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-19",
"last_updated": "2024-06-04",
"certification_date": "2024-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "IN",
"license": "71003121A",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "IN",
"license": "09000192A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201044030",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "815500500",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "gclark@direct.iuhealth.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "5165 McCarty Ln",
"city": "Lafayette",
"state": "IN",
"country_code": "US",
"postal_code": "479058764",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "gclark106166@Direct.Parkviewexchange.com",
"affiliation": "N",
"address_1": "11123 Parkview Plaza Dr Ste 101",
"city": "Fort Wayne",
"state": "IN",
"country_code": "US",
"postal_code": "468451707",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "11123 Parkview Plaza Dr Ste 101",
"city": "Fort Wayne",
"state": "IN",
"country_code": "US",
"postal_code": "468451707",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
"affiliation": "N",
"address_1": "11123 Parkview Plaza Dr Ste 101",
"city": "Fort Wayne",
"state": "IN",
"country_code": "US",
"postal_code": "468451707",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "gclark@direct.iuhealth.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2901 W Jackson St",
"city": "Muncie",
"state": "IN",
"country_code": "US",
"postal_code": "473044307",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.