Jennifer Alicia-Becker Clark, MS, RDN, CSOWM

Primary specialty

Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X

Practice address

2215 Fuller Rd
Ann Arbor, MI 48105-2303

Phone

(517) 764-3609

NPI assigned

Oct 27, 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1912614140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3091 CRABTREE DR",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492867764",
            "telephone_number": "517-605-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 FULLER RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052303",
            "telephone_number": "517-764-3609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4328 Page Ave",
            "address_purpose": "LOCATION",
            "city": "Michigan Center",
            "state": "MI",
            "postal_code": "492541077",
            "country_code": "US",
            "telephone_number": "517-764-3609 x52519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1040 S Winter St Ste 2023",
            "address_purpose": "LOCATION",
            "city": "Adrian",
            "state": "MI",
            "postal_code": "492213876",
            "country_code": "US",
            "telephone_number": "517-764-3609 x52519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JENNIFER",
        "middle_name": "ALICIA-BECKER",
        "name_prefix": "Mrs.",
        "credential": "MS, RDN, CSOWM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-27",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jennifer.clark6@va.gov",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2215 Fuller Rd",
            "city": "Ann Arbor",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481052303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Courtney Beth Clark, NP
• Devon Marie Clark, MD
• Ebonne Clark
• Jacqueline Elizabeth Clark, CNM
• James W. Clark, D.D.S., M.S.
• Kathryn Martens Clark, NP
• Kelly Clark, LMT
• Lisa Ann Clark
• Natasha R Clark, LMSW
• Nicole Ann Clark, LMSW

• Obesity and Weight Management Nutrition Registered Dietitian in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Obesity and Weight Management Nutrition Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.