Steven Glenn Clark, M.D
Individual provider Active NPI Internal Medicine Physician · Cleveland, MS
NPI 1053408476 · NPPES record last updated Nov 5, 2021
Key facts
- NPI
- 1053408476
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 15955 (MS)
- Practice address
- 810 E Sunflower Rd
Cleveland, MS 38732-2800 - Phone
- (662) 843-3606
- NPI assigned
- Oct 6, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 16
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- University of Mississippi School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bolivar Physician Practices LLC
Practice addresses (Care Compare)
810 E Sunflower Rd
Suite 100 a
Cleveland, MS 38732-2828
Phone (662) 843-3606
901 E Sunflower Rd
Cleveland, MS 38732-2833
Phone (662) 846-0061
905 E Sunflower Rd
Cleveland, MS 38732-2833
Phone (662) 843-5371
907 E Sunflower Rd
Cleveland, MS 38732-2830
Hospital & facility affiliations
- Vitalcaring Group
- Adoration Home Health Care Mississippi
- Accentcare Home Health of Greenwood
- Arden Home Health of West Ms, LLC
- Centerwell Home Health
- Hospice of North Sunflower
- Bolivar Medical Center
- North Sunflower Medical Center Cah
- Baptist Memorial Hospital North Ms
- Delta Health System - the Medical Center
- Yalobusha General Hospital
- Delta Rehabilitation and Healthcare Center
- Bolivar Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 12 |
| Removal of skin lesions | 55 |
| Removal of nail tissue | 16 |
| Skin biopsy | 19 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031205000533 | MS | Practitioner - Internal Medicine | 1850296096 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15955 | MS | MD | Internal Medicine Physician |
Practice roles (11 of 12)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Sunflower Medical Center | Current | Accepting new patients | |
| North Sunflower Medical Center | Current |
Accepting new patients | |
| PHC-Cleveland LLC | Current |
Accepting new patients | |
| PHC-Cleveland LLC | Current |
Accepting new patients | |
| North Sunflower Medical Center | Current |
Accepting new patients | |
| Bolivar Physician Practices LLC | Current |
Accepting new patients | |
| Bolivar Physician Practices LLC | Current |
Accepting new patients | |
| PHC-Cleveland LLC | Past | Accepting new patients | |
| Nexion Health at Cleveland, Inc. | Past | Accepting new patients | |
| PHC-Cleveland Inc. | Past | Accepting new patients | |
| Bolivar Physician Practices LLC | Internal Medicine | Past | Accepting new patients |
Locations
810 E Sunflower Rd
Ste 100A
Cleveland, MS 38732
Phone (662) 579-0118
901 E Sunflower Rd
Cleveland, MS 38732
Phone (662) 846-0061
907 E Sunflower Rd
Ste 102
Cleveland, MS 38732
Phone (662) 545-4443
810 E Sunflower Rd
Ste 100
Cleveland, MS 38732
Phone (662) 579-3484
810 E Sunflower Rd
Cleveland, MS 38732
Phone (662) 579-3484
1003 W Sunflower Rd
Cleveland, MS 38733
Phone (479) 459-1507
840 N Oak Ave
Ruleville, MS 38771
Phone (601) 756-2711
330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780
Networks
- LA PPO C-SNP
Interoperability endpoints
- steven.clark.1@10381.direct.athenahealth.com
- clark_steven_g_md@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 15955 | MS | Yes |
Addresses
Primary practice location
810 E Sunflower Rd
Cleveland, MS 38732-2800
Mailing address
425 Norman Cir
Cleveland, MS 38732-9722
Phone (662) 843-5398
Other providers in Cleveland, MS
- John A Carr
- Children'S Acceleration Program, Inc.
- Children'S Dental Clinic
- Cole Clark
- Michael Stuart Clark I
- Cleveland Cardiology PLLC
- Cleveland Children'S Clinic, PLLC
- Cleveland Dental Clinic
- Cleveland Eye Clinic PA
- Cleveland Foot Clinic Inc
All providers in Cleveland, MS · Internal Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.