GINA CLARK APRN NPI 1174912406

NPI Information

  • NPI: 1174912406
  • Provider Name: GINA CLARK, APRN
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4200 GARDINER VIEW AVE
    LOUISVILLE, KY
    ZIP 40213
  • Phone: (502) 456-0494

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NPI Details

Gina Clark, APRN is a primary care nurse practitioner in Louisville, KY with 12 years of experience. Gina Clark, APRN NPI is 1174912406. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
Graduation Year:2014

The provider's business location address is:

4200 GARDINER VIEW AVE
LOUISVILLE, KY
ZIP 40213-877
Phone: (502) 456-0494
Fax: (502) 456-0496

The NPI 1174912406 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)

The enumeration date for this NPI number is 1/9/2015 and was last updated on 8/16/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse Practitioner3008878KENTUCKYNo
2363LG0600XNurse PractitionerGerontology3008878KENTUCKYNo
3363LP2300XNurse PractitionerPrimary Care3008878KENTUCKYYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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