MARIE CLARK
NPI 1124648324
Student in an Organized Health Care Education/Training Program in Indianapolis, IN

Q: What is Marie Clark's NPI number?

The NPI number for Marie Clark is 1124648324. It was assigned to this individual provider in the NPPES registry on April 17, 2020.

Q: What is Marie Clark's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Marie Clark was last updated on April 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 17, 2020PECOS Enrolled

1120 W MICHIGAN ST # CL642, INDIANAPOLIS, IN 46202(317) 278-2686 Get Directions Write a Review

NPPES record last updated: April 17, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Marie Clark NPPES

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

MARIE CLARK (NPI 1124648324) is an individual student in an organized health care education/training program in Indianapolis, Indiana and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124648324

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameMARIE CLARK

Location Address1120 W MICHIGAN ST # CL642Indianapolis, IN 46202-5209

Mailing Address1120 W Michigan St # Cl642Indianapolis, IN 46202-5209

Phone(317) 278-2686

Sole ProprietorNo

Enumeration DateApril 17, 2020

NPPES CertifiedApril 17, 2020

✔ NPI 1124648324 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1120 W MICHIGAN ST # CL642, Indianapolis, IN 46202

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marie Clark is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 20

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

MARTHA ANNA CANCILLA MD

Hospitalist