Katheryn Elisabeth Clark, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

4704328067 Issued in MI

Practice address

100 Michigan St NE # Mc027
Grand Rapids, MI 49503-2560

Phone

(616) 391-1751

Fax

(616) 391-2310

NPI assigned

Apr 3, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spectrum Health HospitalsGroup PAC ID 8921904764, 161 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.39 of 100Reported as group

Quality

85.52

Promoting interoperability

100

Improvement activities

40

Cost

57.34

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kclark268099@epic00.corewelldirect.org
• Direct secure messaging: kclark268099@epic00.shdirect.org

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.

• Spectrum Health Hospitals

  • Hospitalist Physician
  • Grand Rapids, MI
  • NPI 1558407189
  Medicare reassignment Care Compare group NPD
• Ascension Medical Group Promed

  • Family Medicine Physician
  • Portage, MI
  • NPI 1497709869
  Medicare reassignment NPD
• Family Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Kalamazoo, MI
  • NPI 1811065576
  Medicare reassignment NPD
• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment
• Ascension Medical Group Promed

  • Obstetrics & Gynecology Physician
  • Kalamazoo, MI
  • NPI 1437201811
  NPD
• Family Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Kalamazoo, MI
  • NPI 1215768296
  NPD
• Promed Healthcare

  • Rural Health Clinic/Center
  • Plainwell, MI
  • NPI 1487708830
  NPD
• Spectrum Health Hospitals

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  NPD

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1417489931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC027",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-391-1751",
            "fax_number": "616-391-2310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Barclay Ave NE Ste 304",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032527",
            "country_code": "US",
            "telephone_number": "616-391-2160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATHERYN",
        "middle_name": "ELISABETH",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704328067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "330 Barclay Ave NE Ste 304",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032527",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kclark268099@epic00.shdirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "330 Barclay Ave NE Ste 304",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jaedah Clark, LMSW
• Jamillah D Clark
• Janelle Clark
• Jeff Alberto Clark, MD
• Justin Charles Clark, MD
• Kerri Lynn Clark
• Kerrie Clark, LPC
• Keyona R Clark
• Kristen Clark, MS OTR/L
• Kylie Clark

• Advanced Practice Midwife in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Advanced Practice Midwife in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.