Megan Clark, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704314552 Issued in MI

Practice address

21090 Allen Rd
Woodhaven, MI 48183-1602

Phone

(734) 282-1800

Fax

(734) 287-0777

NPI assigned

Oct 24, 2022

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Park Family Health Care PCGroup PAC ID 9638077621, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Park Family Health Care, P.C.

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1437161437
  Medicare reassignment Care Compare group NPD

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

• Oakwood Healthcare Inc

  dba Beaumont Outpatient Diabetes Education

  • Community Health Clinic/Center
  • Dearborn, MI
  • NPI 1790414670

  Hospital

  Care Compare affiliation
• Oakwood Healthcare, Inc.

  dba Beaumont Hospital - Dearborn

  • General Acute Care Hospital
  • Dearborn, MI
  • NPI 1740230119
  Care Compare affiliation

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720310400000",
    "number": "1770200552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9051 NEWPORT CREEK RD",
            "city": "NEWPORT",
            "state": "MI",
            "postal_code": "481667814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21090 ALLEN RD",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481831602",
            "telephone_number": "734-282-1800",
            "fax_number": "734-287-0777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 W Michigan Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481975378",
            "country_code": "US",
            "telephone_number": "544-022-1734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MEGAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2024-07-07",
        "certification_date": "2024-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704314552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabel Rose Chism, CPNP-PC
• Saim Sattar Choudhry, DO
• Christopher R Deangelis D.O (Main Street Physicians P.C.)
• City of Woodhaven
• Jennifer Clancy, PHARM. D
• Comp RX Inc
• Amy Marie Conner, CPHT
• Miranda Cunningham, RN
• D & S Pharmacy LLC (D and S Pharmacy)
• Gino D'Agostino, DPT

• Family Nurse Practitioner in Woodhaven, MI
• Providers in Woodhaven, 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 Jul 7, 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.
• 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.