Michael Jeffery Clark, M.D.

Primary specialty

Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X

License

069783 Issued in GA

Practice address

5671 Peachtree Dunwoody Ste 700
Atlanta, GA 30342-5047

Phone

(404) 847-9999

NPI assigned

Jun 29, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Orthopedic Surgery

Education

Texas Tech University Health Science Center School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082
• Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.clark.p48@direct.tenet.nextgenshare.com
• Direct secure messaging: michael.clark.1@15749.direct.athenahealth.com
• Direct secure messaging: michael.clark.p47@direct.tenet.nextgenshare.com

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.

• Resurgens, LLC

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1386697928
  Medicare reassignment Care Compare group NPD
• Resurgens, LLC

  • Orthopaedic Surgery Physician
  • Braselton, GA
  • NPI 1033919790
  NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

• Kennestone Hospital, Inc.

  • Long Term Care Hospital
  • Marietta, GA
  • NPI 1700853041

  Long-term care hospital

  Care Compare affiliation
• Saint Josephs Hospital of Atlanta Inc

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1679664395
  Care Compare affiliation

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1407143381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5671 PEACHTREE DUNWOODY RD.",
            "address_2": "SUITE 900",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-847-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5671 PEACHTREE DUNWOODY STE 700",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303425047",
            "telephone_number": "404-847-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MICHAEL",
        "middle_name": "JEFFERY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-29",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "4879",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "069783",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "GA",
            "license": "069783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Anne Clark, PA-C
• Lyndsey Clark
• Mark A Clark, MD
• Melinda Clark, LPC
• Michael Dean Clark, M.D.
• Robert Bicknell Clark III, CADC-1
• Sabrina Clark, BSHA
• Sabrina Clark
• Samantha March Clark, D.C.
• Seth Benjamin Clark, BCBA

• Orthopaedic Foot and Ankle Surgery Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Orthopaedic Foot and Ankle Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; 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.