Amy Michelle Clark, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01083310A Issued in IN

Practice address

98 Elm St
Lawrenceburg, IN 47025-2048

Phone

(812) 496-8777

Fax

(812) 537-9974

NPI assigned

May 25, 2017

Last updated

Jul 29, 2024By the provider in NPPES

Sex

Female

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 IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aclark333933@direct-prd.stelizabeth.com

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.

• Summit Medical Group, Inc

  dba St. Elizabeth Physicians Behavioral Health

  • Psychiatry Physician
  • Erlanger, KY
  • NPI 1508287640

  IN

  Medicare reassignment NPD
• Summit Medical Group, Inc

  dba St. Elizabeth Physicians

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216

  Pediatrics

  NPD
• Summit Medical Group, Inc.

  dba St. Elizabeth Physicians

  • Foot & Ankle Surgery Podiatrist
  • Crestview Hills, KY
  • NPI 1043188378
  NPD

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1679001317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "812-496-8777",
            "fax_number": "812-537-9974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 ELM ST",
            "city": "LAWRENCEBURG",
            "state": "IN",
            "postal_code": "470252048",
            "telephone_number": "812-496-8777",
            "fax_number": "812-537-9974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "AMY",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "LL40969",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01083310A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Centers for Foot & Ankle Care LLC
• Ronald C Cheek, M.D.
• Cincinnati Vamc
• City of Lawrenceburg
• City of Lawrenceburg (Lawrenceburg EMS)
• Laura Denise Clark, PMHNP
• Charles Robert Claydon, MD
• Courtney Dawn Clemons, NP
• Elisha Kay Clouse, A.N.P.
• Clovernook Center for the Blind and Visually Impaired

• Pediatrics Physician in Lawrenceburg, IN
• Providers in Lawrenceburg, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.