| NPI | 1376095711 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2016-11-02 |
| Last Updated | 2026-04-09 |
| Authorized Official | Suhas Gandhi Authorized Official Phone: 5022449859 |
| Mailing Address | 2100 Market St Ste 101 Charlestown, IN 47111-9535 United States Phone: (812) 503-5100 | Fax: (770) 573-9513 📍 View Map |
| Primary Practice Address | 1802 E 10th St Jeffersonville, IN 47130-6016 United States Phone: (812) 288-2488 | Fax: (812) 288-6603 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | IN | 300010664 | - |
| MEDICAID | KY | 7100535740 | - |
| Other (non-Medicare) | IN | IN3604 | Medicare IN |
| Other (non-Medicare) | KY | K258180 | Medicare KY |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 261QP2300X – Clinic/Center, Primary Care | - | - |
| No | 261QM0850X – Clinic/Center, Adult Mental Health | - | - |
| No | 324500000X – Substance Abuse Rehabilitation Facility | - | - |
| No | 291U00000X – Clinical Medical Laboratory | - | - |
| No | 261QM2800X – Clinic/Center, Methadone Clinic | - | - |
| No | 208VP0014X – Pain Medicine, Interventional Pain Medicine | - | - |
| No | 207RA0401X – Internal Medicine, Addiction Medicine | - | - |
| No | 261QU0200X – Clinic/Center, Urgent Care | - | - |
| No | 367500000X – Nurse Anesthetist, Certified Registered | - | - |
| No | 2085R0202X – Radiology, Diagnostic Radiology | - | - |
| No | 208600000X – Surgery | - | - |
| No | 261QM1300X – Clinic/Center, Multi-Specialty | - | - |
| No | 251B00000X – Case Management | - | - |
| No | 207RC0000X – Internal Medicine, Cardiovascular Disease | - | - |
| Yes | 208D00000X – General Practice | - | - |
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About NPI 1376095711
North Clark Medical Group Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1376095711. The primary specialty listed is General Practice. The organization is located in Jeffersonville, IN. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2016-11-02. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1376095711?
NPI 1376095711 belongs to North Clark Medical Group Llc, a General Practice in Jeffersonville, IN. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1376095711 active?
The current status of NPI 1376095711 in the NPPES registry is Active. The record was last updated on 2026-04-09.
What specialty is NPI 1376095711?
NPI 1376095711 is classified under the taxonomy General Practice. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1376095711?
You can verify NPI 1376095711 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1376095711?
The primary practice address on file for NPI 1376095711 is 1802 E 10th St, Jeffersonville, IN 47130-6016. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1376095711 issued?
NPI 1376095711 was first issued (enumerated) on 2016-11-02. The NPPES record was last updated on 2026-04-09.
Practice Location Map
North Clark Medical Group Llc is located at 1802 E 10th St, Jeffersonville, IN. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as North Clark Medical Group Llc. All records sourced from the CMS NPPES registry.