Michael Clark, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

812262 Issued in UT

Practice address

1993 Errecart Blvd
Elko, NV 89801-8334

Phone

(775) 753-1049

Fax

(775) 777-8494

NPI assigned

May 11, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, NV2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

University of South Alabama College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premise Health of Nevada Medical Hinitt P CGroup PAC ID 7214822030, 13 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Premise Health of Nevada Medical Hinitt P C

  • Family Medicine Physician
  • Winnemucca, NV
  • NPI 1437185105
  Medicare reassignment Care Compare group NPD
• Castleview Physician Practice LLC

  • Pediatrics Physician
  • Price, UT
  • NPI 1013364884
  Medicare reassignment
• Premise Health of Nevada Medical Hinitt PC

  • Multi-Specialty Clinic/Center
  • Las Vegas, NV
  • NPI 1649977067
  NPD
• Premise Health of Nevada Medical Hinitt PC

  • Family Medicine Physician
  • Elko, NV
  • NPI 1982708574
  NPD
• Castleview Physician Practices, LLC

  • Family Medicine Physician
  • Price, UT
  • NPI 1639484504
  NPD

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1386170348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 E 100 N",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845012504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1993 ERRECART BLVD",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898018334",
            "telephone_number": "775-753-1049",
            "fax_number": "775-777-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "812262",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "7198090-3102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassi Sue Christensen, RBT
• Erin Mae Christensen
• Stephanie L Christensen, CABI
• City of Elko Municipal Water Works
• Marie Civil
• Tiffany Roxanne Clark
• Cheyennne Hope Cleveland
• Clinical Diagnostic Services, LLC
• Josie Clymens, PCW
• Rebecca Jane Colborne, L.M.T., M.M.P.

• Family Nurse Practitioner in Elko, NV
• Providers in Elko, NV by specialty
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.