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CAROL CLARK CNP
NPI 1770535502
Nurse Practitioner - Family in Indianapolis, IN

Active since May 17, 2006
9015 E 17TH ST, INDIANAPOLIS, IN 46229(317) 898-3166(317) 898-4219 Get Directions Write a Review

NPPES record last updated: May 2, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Carol Clark Cnp NPPES

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

CAROL CLARK CNP (NPI 1770535502) is an individual family provider in Indianapolis, Indiana, licensed in Indiana (71000959A) and active in the NPI registry since May 2006.

NPPES Registry Identity

NPI1770535502
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameCAROL CLARKCredential: CNP
Location Address9015 E 17TH STIndianapolis, IN 46229-2016
Mailing Address9015 E 17th StIndianapolis, IN 46229-2016 · (317) 898-3166 · Fax (317) 898-4219
Phone(317) 898-3166
Fax(317) 898-4219
Sole ProprietorNo
Enumeration DateMay 17, 2006
Last NPPES UpdateMay 2, 2012
✔ NPI 1770535502 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IN · 71000959A
Also ListedNurse Practitioner · Community HealthTaxonomy 363LC1500X · License 71000959A (IN)
9015 E 17TH ST, Indianapolis, IN 46229
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Other Identifiers 6

Medicare UPINP54690
OtherP01016729IN · Rr Medicare Ptan
Medicare UPIN232230QQQIN
Medicaid200307710IN
Medicare PIN213820DIN
Medicare ID-Type Unspecified192980BIN

Other Providers at the Same Location NPPES 7

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

FAROUK KHAIRY
Family Medicine
9015 E 17TH ST
INDIANAPOLIS, IN 46229
Marion County (317) 355-7700
LEANN S EMERY NP
Nurse Practitioner (Family)
9015 E 17TH ST
INDIANAPOLIS, IN 46229
Marion County (317) 355-7700
COMMUNITY HOSPITALS OF INDIANA INC
Internal Medicine
9015 E 17TH ST
INDIANAPOLIS, IN 46229
Marion County (317) 898-3166
RODDREA MONTGOMERY MD
Family Medicine
9015 E 17TH ST
INDIANAPOLIS, IN 46229
Marion County (317) 355-7700
COMMUNITY HOSPITALS OF INDIANA INC
Family Medicine
9015 E 17TH ST
INDIANAPOLIS, IN 46229
Marion County (317) 898-3166
BETH E PRETTI FNP
Nurse Practitioner (Family)
9015 E 17TH ST
INDIANAPOLIS, IN 46229
Marion County (317) 355-7700
MELISSA JANE SMITH NP-C
Nurse Practitioner (Family)
9015 E 17TH ST
INDIANAPOLIS, IN 46229
Marion County (317) 355-7700

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 Carol Clark's NPI number?

The NPI number for Carol Clark is 1770535502. It was assigned to this individual provider in the NPPES registry on May 17, 2006.

Where is Carol Clark located?

Carol Clark practices at 9015 E 17th St, Indianapolis, IN 46229. The listed phone number is (317) 898-3166.

What is Carol Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Carol Clark was last updated on May 2, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.