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JEREMY J CLARK M.D.
NPI 1588717417
Obstetrics & Gynecology - Gynecology in Louisville, KY

Active since January 22, 2007PECOS EnrolledAccepts Medicare Assignment
401 E CHESTNUT ST, SUITE 410, LOUISVILLE, KY 40202(502) 271-5999(502) 271-5994 Get Directions Write a Review

NPPES record last updated: November 29, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jeremy J Clark M.d. NPPES

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

JEREMY J CLARK M.D. (NPI 1588717417) is an individual gynecology provider in Louisville, Kentucky, licensed in Kentucky (41069) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS and is a graduate of Wright State University Boonshoft School Of Medicine (2003).

NPPES Registry Identity

NPI1588717417
Entity TypeIndividualMale
Primary Taxonomy207VG0400X
Provider Legal NameJEREMY J CLARKCredential: M.D.
Location Address401 E CHESTNUT ST, SUITE 410Louisville, KY 40202-5700
Mailing Address550 S Jackson St Fl 2, Dept Ob/gyn Att Vicki MastersonLouisville, KY 40202-1622
Phone(502) 271-5999
Fax(502) 271-5994
Sole ProprietorNo
Medical School CMSWright State University Boonshoft School Of MedicineGraduated 2003
Enumeration DateJanuary 22, 2007
Last NPPES UpdateNovember 29, 2021
✔ NPI 1588717417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207VG0400X
License✔ Licensed in KY · 41069
Definition
A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee
401 E CHESTNUT ST, Louisville, KY 40202
Open in Google Maps ↗

Other Identifiers 10

Other50016301KY · Passport Speciality - Psc
Other000000522820KY · Anthem Foundation
Other000000542980KY · Anthem - Psc
Other000001568FHumana Psc
Other50016302KY · Passport Speciality# -foundation
Other50017315KY · Passport Pcp# - Foundation
Medicaid200868450IN
Other7290926Aetna
Other000001172THumana Foundation
Medicaid7100013410KY

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

Jeremy J Clark M.d. 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 ID8022117233
PECOS Enrollment IDI20101101000345
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40202 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
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
Most-billed visit code 99213
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 20

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

DR. CHRISTOPHER R. SHAFER M.D.
Psychiatry & Neurology (Neurology)
401 E CHESTNUT ST, SUITE 510
LOUISVILLE, KY 40202
Jefferson County (502) 588-4800
KELLI M. BULLARD DUNN MD
Colon & Rectal Surgery
401 E CHESTNUT ST, SUITE 710
LOUISVILLE, KY 40202
Jefferson County (502) 583-8303
JASON WAYNE SMITH MD
Surgery (Surgical Critical Care)
401 E CHESTNUT ST, SUITE 710
LOUISVILLE, KY 40202
Jefferson County (502) 583-8303
SRI PRAKASH L MOKSHAGUNDAM MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
401 E CHESTNUT ST, STE #310
LOUISVILLE, KY 40202
Jefferson County (502) 588-4600
DR. VICTORIA SKELTON YUNKER MD.
Psychiatry & Neurology (Psychiatry)
401 E CHESTNUT ST, SUITE 610
LOUISVILLE, KY 40202
Jefferson County (502) 588-4450
THERESA BRADSHAW BS
Occupational Therapist (Neurorehabilitation)
401 E CHESTNUT ST, SUITE 510
LOUISVILLE, KY 40202
Jefferson County (502) 589-0802
UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION
Surgery (Trauma Surgery)
401 E CHESTNUT ST, SUITE 710
LOUISVILLE, KY 40202
Jefferson County (502) 583-8303
UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION
Psychiatry & Neurology (Neurology)
401 E CHESTNUT ST, SUITE 510
LOUISVILLE, KY 40202
Jefferson County (502) 589-0802

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeremy Clark's NPI number?

The NPI number for Jeremy Clark is 1588717417. It was assigned to this individual provider in the NPPES registry on January 22, 2007.

Where is Jeremy Clark located?

Jeremy Clark practices at 401 E Chestnut St Suite 410, Louisville, KY 40202. The listed phone number is (502) 271-5999.

What is Jeremy Clark's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecology, with taxonomy code 207VG0400X.

Is Jeremy Clark enrolled in Medicare?

Yes. Jeremy Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jeremy Clark was last updated on November 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.