Molly Marie Clark, DNP, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704290182 Issued in MI

Practice address

2812 W Cadillac Dr
Farwell, MI 48622-9757

Phone

(989) 588-5050

Fax

(989) 588-5052

NPI assigned

Dec 19, 2018

Last updated

Oct 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, NY2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: moclark@landmarkhealth-direct.org

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.

• University Physician Group

  dba Wayne Health

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  • Detroit, MI
  • NPI 1447299797

  Single Specialty

  Medicare reassignment NPD
• Brookview Medical Associates, PLLC

  • General Practice Physician
  • Bohemia, NY
  • NPI 1871965855

  Single Specialty

  Medicare reassignment NPD
• Vedha Health Services PLLC

  • Family Medicine Physician
  • Royal Oak, MI
  • NPI 1578334058
  Medicare reassignment
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MI

  Medicare reassignment

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1700358439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13409 E 14 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483126304",
            "telephone_number": "586-977-3900",
            "fax_number": "586-977-6084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 W CADILLAC DR",
            "city": "FARWELL",
            "state": "MI",
            "postal_code": "486229757",
            "telephone_number": "989-588-5050",
            "fax_number": "989-588-5052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13409 E 14 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Sterling Heights",
            "state": "MI",
            "postal_code": "483126304",
            "country_code": "US",
            "telephone_number": "586-977-3900",
            "fax_number": "586-977-6084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MOLLY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-19",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704290182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Brewer
• Michael Brewer
• Quinci Anne Butler
• Stacy Carstensen, FNP
• Central Michigan Family Practice
• Colleen Quesada DMD PLLC (Farwell Family Dentistry)
• Country Care Assisted Living
• Sharon Lynn Dewey
• Lacie K Dewitt, RBT
• Jodi Ann Drenth, DNP

• Family Nurse Practitioner in Farwell, MI
• Providers in Farwell, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.