DR. NICOLE C. CLARK DO
NPI 1083110225
Family Medicine in Lebanon, IN

Q: What is Nicole Clark's NPI number?

The NPI number for Nicole Clark is 1083110225. It was assigned to this individual provider in the NPPES registry on April 5, 2018. The provider is also known as Nicole C. Schmitt.

Q: What is Nicole Clark's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Clark was last updated on October 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 05, 2018PECOS EnrolledAccepts Medicare Assignment

2705 N LEBANON ST STE 300, LEBANON, IN 46052(765) 485-8649(765) 485-8650 Get Directions Write a Review

NPPES record last updated: October 10, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 10, 2023, Sep 6, 2023, Sep 30, 2021 and 1 more (4 updates tracked since 2021).

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About Dr. Nicole C. Clark Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICOLE C. CLARK DO (NPI 1083110225) is an individual family medicine provider in Lebanon, Indiana, licensed in Indiana (02006481A) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS, is affiliated with Witham Health Services, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1083110225

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. NICOLE C. CLARKCredential: DO

Location Address2705 N LEBANON ST STE 300Lebanon, IN 46052-8622

Mailing Address2605 N Lebanon StLebanon, IN 46052-1476

Phone(765) 485-8649

Fax(765) 485-8650

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateApril 5, 2018

Last NPPES UpdateOctober 10, 20234 updates tracked since enumeration

NPPES CertifiedOctober 10, 2023

✔ NPI 1083110225 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IN · 02006481A

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2705 N LEBANON ST STE 300, Lebanon, IN 46052

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Other Names 1

Former Name (1)Nicole C. Schmitt

Other Identifiers 1

Medicaid300014551IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Nicole C. Clark Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6305191461

PECOS Enrollment IDI20210727000749

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

131 services78 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

115 services63 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

50 services50 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

27 services26 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

16 services16 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

14 services13 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Witham Health Services

Acute Care Hospitals · Lebanon, IN

4/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number150104

Location2605 N Lebanon StLebanon, IN 46052 · Boone County

Emergency services Birthing friendly

Indiana University Health Frankfort Inc

Critical Access Hospitals · Frankfort, IN

OwnershipVoluntary non-profit - Private

CMS Certification Number151316

Location1300 S Jackson StFrankfort, IN 46041 · Clinton County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46052 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMMA JOY NORDSTROM MD

Family Medicine