Record summary
Nicole Tristin Marie Clark appears in the HHS-OIG List of Excluded Individuals/Entities (LEIE) public dataset as an individual record associated with South Thomaston, Maine. The latest imported LEIE dataset lists this record as currently excluded from participation in federally funded health care programs. The exclusion date shown in the source record is October 20, 2021, and the exclusion type is 1128b4, identified by HHS-OIG as license revocation, suspension, or surrender.
Source record
What this exclusion type means
HHS-OIG identifies exclusion type 1128b4 as “License revocation, suspension, or surrender.” License revocation, suspension, or surrender (permissive exclusion).
This exclusion type is a statutory category used by HHS-OIG in the LEIE dataset. The category describes the legal authority associated with the exclusion record, not a separate investigation or additional reporting by Excluded Provider.
Location and provider classification
This LEIE record is associated with South Thomaston, ME 04092. The listed provider category is Individual - Licensed Health Care Service Provider. The listed specialty is Nurse / Nurses Aide.
NPI Registry context
The LEIE record lists NPI 1841609484. CMS NPPES public registry data lists this NPI as an individual record with primary taxonomy Emergency Medicine, Sports Medicine (207PS0010X). Registered practice location: Portland, ME. NPI enumeration date: Aug 7, 2014. NPPES status: Active. The NPI Registry lists credential: ATC-L.
NPI Registry data is administrative provider-identification data from CMS. It does not independently verify or explain the HHS-OIG exclusion record above. Verify exclusion status directly with HHS-OIG.
How to verify this record
This page is a public-record summary and should be treated as a possible LEIE match, not final identity verification. To verify the record, use the official HHS-OIG LEIE search and compare available identifying information through the official process. Name, location, provider category, specialty, exclusion date, and NPI should be treated as matching clues rather than final proof of identity.
What this page does not include
This page summarizes the HHS-OIG LEIE public dataset only. It does not search state Medicaid exclusion lists, state licensing-board actions, court records, malpractice records, employment history, civil lawsuits, or non-public investigations.
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