GINA CLARK (APRN) – Primary Care Nurse Practitioner, NPI 1174912406
Primary Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,347 NURSE PRACTITIONER in KY
Provider Addresses for GINA CLARK (APRN)
3120 RUNNYMEDE RD
LOUISVILLE, KY 402226144
Phone: (502) 657-1076
Fax: (888) 959-2460
Type: Mailing
4200 GARDINER VIEW AVE
LOUISVILLE, KY 402131877
Phone: (502) 456-0494
Fax: (502) 456-0496
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $265.
Total Amount is formed as General ($265) + Research ($0) + Ownership ($0) = $265.
Last reported payment date: 2024-11-12 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($127).
Total Amount
$265
General + Research + Ownership
Payments
9
Total payment records
General Amount
$265
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-12
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2015-03-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150312000921 | I | Nurse Practitioner | KY | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 54 | 21 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 48 | 12 | $0 |
Insurance plans in this area (ZIP 40222)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| - | KY | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY |
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