Active NPI
Bonnie Lou Clark, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Jeffersonville, IN
National Provider Identifier
1831472133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 71003710A
- Practice address
- 131 E Court Ave Ste 101
Jeffersonville, IN 47130-3600 - Phone
- (502) 208-1357
- Fax
- (812) 248-3388
- NPI assigned
- Sep 22, 2011
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 71003710A | IN | Primary |
| Family Nurse Practitioner | 363LF0000X | 71003710A | IN |
Addresses
Primary practice location
131 E Court Ave Ste 101
Jeffersonville, IN 47130-3600
Mailing address
3018 Plantation Dr
Sellersburg, IN 47172-9174
Phone (502) 208-1357
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71003710A | IN | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tabler Clinical Services, PSC | Family | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775174400000",
"number": "1831472133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3018 PLANTATION DR",
"city": "SELLERSBURG",
"state": "IN",
"postal_code": "471729174",
"telephone_number": "502-208-1357",
"fax_number": "812-248-3388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 E COURT AVE STE 101",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "471303600",
"telephone_number": "502-208-1357",
"fax_number": "812-248-3388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "BONNIE",
"middle_name": "LOU",
"name_prefix": "Ms.",
"credential": "PMHNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-22",
"last_updated": "2026-04-03",
"certification_date": "2026-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IN",
"license": "71003710A",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71003710A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jeffersonville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.