Active NPI
Taylor Clark
- Registered Nurse
- Lake Orion, MI
National Provider Identifier
1023937901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 4704328153
- Practice address
- 1621 Bayview St
Lake Orion, MI 48362-2204 - Phone
- (248) 931-9356
- NPI assigned
- Jul 14, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704328153 | MI | Primary |
Addresses
Primary practice location
1621 Bayview St
Lake Orion, MI 48362-2204
Mailing address
1621 Bayview St
Lake Orion, MI 48362-2204
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1783987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1023937901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1621 BAYVIEW ST",
"city": "LAKE ORION",
"state": "MI",
"postal_code": "483622204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1621 BAYVIEW ST",
"city": "LAKE ORION",
"state": "MI",
"postal_code": "483622204",
"telephone_number": "248-931-9356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "TAYLOR",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2026-07-14",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704328153",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Orion, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.