Shelby Clark

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

225 Crosslake Dr
Evansville, IN 47715-8198

Phone

(812) 477-1558

NPI assigned

Jul 23, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri-State Orthopaedic Surgeons Inc 60 clinicians

Orthopaedics-Indianapolis Inc 357 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent Evansville Hospital, Evansville, IN, CCN 150100

Merit-based Incentive Payment System (MIPS)

Final score

66.6 of 100Reported as group

Quality

60.71

Promoting interoperability

33

Improvement activities

40

Cost

83.78

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Tri-State Orthopaedic Surgeons, Inc.

  • Orthopaedic Surgery Physician
  • Evansville, IN
  • NPI 1073501003

  IN, Physician Assistant

  Medicare reassignment Care Compare group NPD
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Indianapolis, IN
  • NPI 1336252451

  IN, Physician Assistant

  Medicare reassignment Care Compare group NPD (past)
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Indianapolis, IN
  • NPI 1073622015
  Care Compare group NPD
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Terre Haute, IN
  • NPI 1285433953
  Care Compare group NPD
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Kokomo, IN
  • NPI 1003615774
  Care Compare group
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Westfield, IN
  • NPI 1013371277
  Care Compare group
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Indianapolis, IN
  • NPI 1134431125
  Care Compare group
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Greenfield, IN
  • NPI 1194524876
  Care Compare group
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Lafayette, IN
  • NPI 1225737950
  Care Compare group
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Warsaw, IN
  • NPI 1316899768
  Care Compare group
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Westfield, IN
  • NPI 1457150138
  Care Compare group
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Greenwood, IN
  • NPI 1457443764
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Mary'S Health, Inc.

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1427082957

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1982257507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CROSSLAKE DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477158198",
            "telephone_number": "812-477-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CROSSLAKE DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477158198",
            "telephone_number": "812-477-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SHELBY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Clark
• Jillian Clark, RN
• Melinda A Clark, NP
• Neringa Clark, COTA
• Richard Michael Clark, D.O.
• Thomas David Clark, O.D.
• Timothy Clark
• Nell M Clay, NP
• Anna Claybon
• Keri Renee Claybourn, PT

• All providers in Evansville, IN
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; 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.

Verify at the official NPI Registry.