Clean Health Medical, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CLEAN HEALTH MEDICAL, LLC

Practice address

2101 Broadway St
Clarksville, IN 47129-7800

Phone

(812) 913-6880

NPI assigned

Mar 4, 2025

Organization subpart

No

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

Authorized official

Name

Jalaram Patel, DONPI 1366893539

Title

Owner

Phone

(812) 913-6880

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jalaram Patel, DO

  • Internal Medicine Physician
  • New Albany, IN
  • NPI 1366893539

  IN, Internal Medicine, KY

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1741046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1831997055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 BROADWAY ST",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471297800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 BROADWAY ST",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471297800",
            "telephone_number": "812-913-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAN HEALTH MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-04",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "JALARAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-913-6880",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Clarksville, IN
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.