Edith Clark, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

EC001742 Issued in MI

Practice address

125 Dwyer St
Clare, MI 48617-1002

Phone

(989) 386-9721

NPI assigned

Feb 23, 2006

Last updated

Jun 10, 2010By 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 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

William M. Scholl College of Podiatric Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edith Clark DPM PLLCGroup PAC ID 0547246464, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mymichigan Medical Center Clare Hospital, Clare, MI, CCN 230180
• Mymichigan Medical Center Gladwin Hospital, Gladwin, MI, CCN 231325

Merit-based Incentive Payment System (MIPS)

Final score

12.3 of 100Reported as individual

Quality

15

Improvement activities

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Edith Clark DPM PLLC

  • Podiatrist
  • Clare, MI
  • NPI 1023174273
  Medicare reassignment Care Compare group NPD Authorized official

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

• Mymichigan Medical Center Clare

  • General Acute Care Hospital
  • Clare, MI
  • NPI 1568414589
  Care Compare affiliation
• Mymichigan Medical Center Gladwin

  • Critical Access Hospital
  • Gladwin, MI
  • NPI 1235248071
  Care Compare affiliation

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276128000000",
    "number": "1770559528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 LEONARD ST NW",
            "address_2": "SUITE 103",
            "city": "WALKER",
            "state": "MI",
            "postal_code": "495348447",
            "telephone_number": "616-453-6329",
            "fax_number": "616-453-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 DWYER ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486171002",
            "telephone_number": "989-386-9721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "EDITH",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2010-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "EC001742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4613888",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clare Gladwin Resd
• Clare Hometown Chiropractic PC
• Clare Opco LLC (Medilodge of Clare)
• Thomas Claringbold, D.O
• Clarity Optical, LLC
• Judith J Cline, R.PH.
• Jamie Lynn Clute, PTA
• Candace Comer
• Judith Ann Correll, MT
• Countryside Chiropractic Center PLC

• Podiatrist in Clare, MI
• Providers in Clare, MI by specialty
• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; 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.