Active NPI
Sheree Clark, M.D.
- Family Medicine Physician
- Midland, MI
National Provider Identifier
1033138987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- SC043896
- Practice address
- 4401 N Campus Ridge Dr
Suite 2100
Midland, MI 48640-6112 - Phone
- (989) 837-9300
- Fax
- (989) 837-9307
- NPI assigned
- Jul 19, 2006
- Last updated
- Sep 6, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | SC043896 | MI | Primary |
Addresses
Primary practice location
4401 N Campus Ridge Dr
Suite 2100
Midland, MI 48640-6112
Mailing address
4401 N Campus Ridge Dr
Midland, MI 48640-6112
Phone (989) 837-9300
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC043896 | MI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346889600000",
"number": "1033138987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4401 N CAMPUS RIDGE DR",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486406112",
"telephone_number": "989-837-9300",
"fax_number": "989-837-9307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4401 N CAMPUS RIDGE DR",
"address_2": "SUITE 2100",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486406112",
"telephone_number": "989-837-9300",
"fax_number": "989-837-9307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "SHEREE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-19",
"last_updated": "2012-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "SC043896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.