Active NPI
Elizabeth F Clark, MSC, PA-C
- Physician Assistant
- Appleton, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3925-23
- Practice address
- 1818 N Meade St
Appleton, WI 54911-3454 - Phone
- (920) 731-4101
- NPI assigned
- Aug 31, 2016
- Last updated
- Oct 6, 2025
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3925-23 | WI | Primary |
Addresses
Primary practice location
1818 N Meade St
Appleton, WI 54911-3454
Mailing address
1818 N Meade St
Appleton, WI 54911-3454
Phone (507) 450-6906
Other practice location 1
619 N Segoe Rd
Apt 810
Madison, WI 53705-3112
Phone (507) 450-6906
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | eclark361427@ewd.direct.hshs.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Boston University School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2502 S Ashland Ave
Green Bay, WI 54304-5252
Phone (920) 496-4700
3021 Voyager Dr
Green Bay, WI 54311-8303
Phone (920) 496-4700
835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 496-4700
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3925-23 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Nicholas Hospital-Sisters of the Third Order of St Francis | Current | Accepting new patients | |
| St Vincent Hospital-Hospital Sisters-Third Order of St Francis | Current | Accepting new patients | |
| St Nicholas Hospital-Sisters of the Third Order of St Francis | Current | Accepting new patients | |
| St Vincent Hospital-Hospital Sisters-Third Order of St Francis | Current | Accepting new patients | |
| Prevea Clinic, Inc. | Current | Accepting new patients |
Locations
1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016
2502 S Ashland Ave
Green Bay, WI 54304
Phone (920) 496-4750
835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246
3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710
Interoperability endpoints
- eclark361427@ewd.direct.hshs.org
- hkloster1142178@direct.uwhealth.org
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Prevea Health
- General Practice Physician
- Green Bay, WI
- NPI 1285613638
-
- Internal Medicine Physician
- Green Bay, WI
- NPI 1306869276
-
- Emergency Medicine Physician
- Appleton, WI
- NPI 1588666853
-
dba Prevea Sheboygan Health Center
- Internal Medicine Physician
- Sheboygan, WI
- NPI 1275799413
-
dba St Nicholas Hospital Professional Services Group
- Nurse Practitioner
- Sheboygan, WI
- NPI 1275943243
-
dba St. Nicholas Hospital
- Internal Medicine Physician
- Sheboygan, WI
- NPI 1447737762
-
dba Prevea Health
- Durable Medical Equipment & Medical Supplies
- Green Bay, WI
- NPI 1245042530
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba ThedaCare Medical Center Orthopedics, Spine, and Pain
- General Acute Care Hospital
- Appleton, WI
- NPI 1740920909
-
- General Acute Care Hospital
- Appleton, WI
- NPI 1497119218
-
- General Acute Care Hospital
- Appleton, WI
- NPI 1689038408
-
dba WI Veterans Village Physical Therapy
- General Acute Care Hospital
- Appleton, WI
- NPI 1831773589
-
- General Acute Care Hospital
- Appleton, WI
- NPI 1902832306
-
dba ThedaCare Medical Center - Fond Du Lac
- General Acute Care Hospital
- Fond Du Lac, WI
- NPI 1912721002
-
dba ThedaCare Medical Center - Oshkosh
- General Acute Care Hospital
- Oshkosh, WI
- NPI 1912880329
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759708800000",
"number": "1053867853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1818 N MEADE ST",
"city": "APPLETON",
"state": "WI",
"postal_code": "549113454",
"telephone_number": "507-450-6906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1818 N MEADE ST",
"city": "APPLETON",
"state": "WI",
"postal_code": "549113454",
"telephone_number": "920-731-4101"
}
],
"practiceLocations": [
{
"address_1": "619 N Segoe Rd",
"address_2": "Apt 810",
"address_purpose": "LOCATION",
"city": "Madison",
"state": "WI",
"postal_code": "537053112",
"country_code": "US",
"telephone_number": "507-450-6906",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLARK",
"first_name": "ELIZABETH",
"middle_name": "F",
"credential": "MSC, PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-31",
"last_updated": "2025-10-06",
"certification_date": "2025-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "3925-23",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "eclark361427@ewd.direct.hshs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "2502 S Ashland Ave",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543045252",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.