Active NPI
Melissa Aviva Clark, M.D.
- Family Medicine Physician
- Hunt Valley, MD
National Provider Identifier
1346236775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- D70056
- Practice address
- 101 Schilling Rd
Hunt Valley, MD 21031-1104 - Phone
- (410) 881-3953
- NPI assigned
- Sep 21, 2005
- Last updated
- Sep 25, 2026
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036-105536 | IL | |
| Family Medicine Physician | 207Q00000X | D70056 | MD | Primary |
Addresses
Primary practice location
101 Schilling Rd
Hunt Valley, MD 21031-1104
Mailing address
101 Schilling Rd
Hunt Valley, MD 21031-1104
Phone (410) 881-3953
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036-105536 | Medicaid | IL |
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 |
|---|---|---|---|
| 036-105536 | IL | MD | Family Medicine Physician |
| D70056 | MD | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| MJ Medical Group SC | Family Medicine | Past | Accepting new patients |
| Michael Jutovsky MD LLC | Family Medicine | Past | Accepting new patients |
Organizations & group practices 3
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 Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Family Medicine Physician
- Chicago, IL
- NPI 1649224148
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790294400000",
"number": "1346236775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 SCHILLING RD",
"city": "HUNT VALLEY",
"state": "MD",
"postal_code": "210311104",
"telephone_number": "410-881-3953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 SCHILLING RD",
"city": "HUNT VALLEY",
"state": "MD",
"postal_code": "210311104",
"telephone_number": "410-881-3953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "MELISSA",
"middle_name": "AVIVA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-21",
"last_updated": "2026-09-25",
"certification_date": "2026-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036-105536",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "D70056",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036-105536",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hunt Valley, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.