Jacob Nicholas Clark, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601011462 Issued in MI

Practice address

1140 E Michigan Ave Ste 400
Lansing, MI 48912-1806

Phone

(517) 364-9650

NPI assigned

Oct 31, 2022

Sex

Male

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

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

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edward W Sparrow Hospital AssociationGroup PAC ID 6709799166, 698 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Edward W. Sparrow Hospital Association

  dba Sparrow Regional Children's Center

  • Pediatrics Physician
  • Lansing, MI
  • NPI 1831139088
  Medicare reassignment Care Compare group
• Sparrow Ionia Hospital

  dba University of Michigan Health-Sparrow Ionia

  • Critical Access Hospital
  • Ionia, MI
  • NPI 1700820065
  Medicare reassignment NPD (past)
• Sparrow Carson Hospital

  dba University of Michigan Health-Sparrow

  • Internal Medicine Physician
  • Carson City, MI
  • NPI 1598490542
  Medicare reassignment
• Sparrow Clinton Hospital

  dba University of Michigan Health-Sparrow Clinton

  • Critical Access Hospital
  • Saint Johns, MI
  • NPI 1093809824
  Medicare reassignment
• Sparrow Clinton Hospital

  dba University of Michigan Health-Sparrow Clinton Hospital Emergency Depar

  • Emergency Medicine Physician
  • Saint Johns, MI
  • NPI 1396827952
  Medicare reassignment
• Sparrow Eaton Hospital

  dba University of Michigan Health-Sparrow Charlotte Orthopedics

  • Orthopaedic Surgery Physician
  • Charlotte, MI
  • NPI 1043419427
  Medicare reassignment
• Sparrow Eaton Hospital

  dba University of Michigan Health-Sparrow Eaton

  • Critical Access Hospital
  • Charlotte, MI
  • NPI 1942254529
  Medicare reassignment
• Edward W Sparrow Hospital Association

  dba University of Michigan Health-Sparrow

  • Adult Health Nurse Practitioner
  • Lansing, MI
  • NPI 1265220438
  NPD
• Edward W. Sparrow Hospital Association

  dba Sparrow Cardiovascular & Thoracic Surgeons

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lansing, MI
  • NPI 1033162326
  NPD
• Sparrow Carson Hospital

  dba University of Michigan Health-Sparrow

  • Rural Health Clinic/Center
  • Carson City, MI
  • NPI 1013987833
  NPD (past)
• Sparrow Clinton Hospital

  dba SMG St Johns

  • Multi-Specialty Clinic/Center
  • Saint Johns, MI
  • NPI 1306893078
  NPD (past)
• Sparrow Eaton Hospital

  dba University of Michigan Health-Sparrow

  • Ambulance
  • Charlotte, MI
  • NPI 1093742249
  NPD (past)

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

• Edward W Sparrow Hospital Association

  dba University of Michigan Health-Sparrow Lansing

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1073588711
  Care Compare affiliation
• Edward W Sparrow Hospital Association

  dba Thoracic Cardiovascular Institute

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1760710719
  Care Compare affiliation

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1972210920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13008",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489013008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 E MICHIGAN AVE STE 400",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121806",
            "telephone_number": "517-364-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JACOB",
        "middle_name": "NICHOLAS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-31",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Clark-Brownell, LPN
• Ashlie E Clark
• August John Clark, D.O.
• Courtney Clark
• Helayne Christine Clark
• Logan Clark, DO
• Marissa Clark, SWT
• Marsha J Clark, M.A., L.L.C.P.
• Michael R Clark, MD
• Robert C Clark, L.P.C.

• Physician Assistant in Lansing, MI
• Providers in Lansing, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; 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.