Active NPI
David Daniel Clark II, D.O.
- Emergency Medicine Physician
- Mount Clemens, MI
National Provider Identifier
1588893432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 5101018227
- Practice address
- 1000 Harrington St
Mount Clemens, MI 48043-2920 - Phone
- (989) 621-0019
- NPI assigned
- Jul 13, 2009
- Last updated
- Jul 25, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 5101018227 | MI | |
| Emergency Medicine Physician | 207P00000X | 5101018227 | MI | Primary |
Addresses
Primary practice location
1000 Harrington St
Mount Clemens, MI 48043-2920
Mailing address
32 Eldredge St
Mount Clemens, MI 48043-5408
Phone (989) 621-0019
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Michigan State University College of Osteopathic Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
50 N Perry St
Pontiac, MI 48342-2217
Phone (248) 338-5000
72 S State St
Lakeshore Campus
Shelby, MI 49455-1228
Phone (231) 728-4601
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Interoperability endpoints
- dclark2070418@direct.trinity-health.org
Organizations & group practices 2
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.
-
- Emergency Medicine Physician
- Muskegon, MI
- NPI 1124574520
-
- Emergency Medicine Physician
- Flint, MI
- NPI 1942026174
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rural Acute Care Hospital
- Mt Pleasant, MI
- NPI 1619941317
-
dba Munson Healthcare Cadillac Physician Network
- Family Medicine Physician
- Cadillac, MI
- NPI 1487051611
Hospital
-
- General Acute Care Hospital
- Cadillac, MI
- NPI 1841696754
-
- Rural Acute Care Hospital
- Grayling, MI
- NPI 1083010953
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343174400000",
"number": "1588893432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 ELDREDGE ST",
"city": "MOUNT CLEMENS",
"state": "MI",
"postal_code": "480435408",
"telephone_number": "989-621-0019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 HARRINGTON ST",
"city": "MOUNT CLEMENS",
"state": "MI",
"postal_code": "480432920",
"telephone_number": "989-621-0019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "DAVID",
"middle_name": "DANIEL",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-13",
"last_updated": "2012-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "MI",
"license": "5101018227",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MI",
"license": "5101018227",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Clemens, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; 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.