Dexter D Clark, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101023137 Issued in MI

Practice address

1414 W Fair Ave
Suite 36
Marquette, MI 49855-2675

Phone

(906) 225-3867

NPI assigned

Apr 24, 2017

Last updated

Oct 19, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Michigan State University College of Osteopathic Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DLP Marquette Physician Practices IncGroup PAC ID 9931359601, 193 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uphs Marquette DLP Hospital Hospital, Marquette, MI, CCN 230054

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dexter.clark.1@8233.direct.athenahealth.com

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.

• DLP Marquette Physician Practices Inc

  dba Marquette General Family Medicine - Marquette

  • Obesity Medicine (Internal Medicine) Physician
  • Marquette, MI
  • NPI 1487902995

  Family Medicine

  Medicare reassignment Care Compare group NPD
• DLP Marquette Physician Practices Inc

  dba UP Health System Pediatric Specialists

  • Rural Health Clinic/Center
  • Marquette, MI
  • NPI 1205635760
  NPD
• DLP Marquette General Hospital LLC

  dba UP Health System Marquette

  • General Acute Care Hospital
  • Marquette, MI
  • NPI 1568727048
  NPD (past)
• DLP Marquette Physician Practices Inc

  dba Marquette General Emergency Medicine

  • Emergency Medicine Physician
  • Marquette, MI
  • NPI 1366790727
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• DLP Marquette General Hospital LLC

  dba UP Health System Marquette

  • General Acute Care Hospital
  • Marquette, MI
  • NPI 1568727048
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1265967665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13811",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154029",
            "telephone_number": "906-225-3630",
            "fax_number": "906-225-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "SUITE 36",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-3867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DEXTER",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-24",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101023137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Lee Christiansen
• Jennifer Cain Cihak, LMSW
• Cassandra Suzanne Cira, LLMSW
• City of Marquette
• Denise Clark
• Suzanne Marie Clarke, MD
• Brian Classen, HIS
• Brian William Claus, AT, ATC, CSCS
• Mariah Ellen Clement
• Mary H Clifford, D.D.S.

• Family Medicine Physician in Marquette, MI
• Providers in Marquette, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.

Verify at the official NPI Registry.