Samantha Anne Clark, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

5101022012 Issued in MI

Practice address

1215 E Michigan Ave
Lansing, MI 48912

Phone

(207) 205-7674

NPI assigned

Jun 19, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: syamil149399@mymichiganhealth.midirect.net

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 NPD
• Mymichigan Medical Center Alma

  • Emergency Medicine Physician
  • Alma, MI
  • NPI 1568914422
  Medicare reassignment NPD
• Mymichigan Medical Center Alpena

  • Emergency Medicine Physician
  • Alpena, MI
  • NPI 1508332792
  Medicare reassignment NPD
• Mymichigan Medical Center Gladwin

  • General Practice Physician
  • Gladwin, MI
  • NPI 1881869774
  Medicare reassignment NPD
• Edward W Sparrow Hospital Association

  dba University of Michigan Health-Sparrow

  • Adult Health Nurse Practitioner
  • Lansing, MI
  • NPI 1265220438
  NPD
• Mymichigan Medical Center Alma

  • Family Medicine Physician
  • Alma, MI
  • NPI 1265596126
  NPD
• Mymichigan Medical Center Alpena

  • Internal Medicine Physician
  • Alpena, MI
  • NPI 1942302302
  NPD
• Mymichigan Medical Center Gladwin

  • Medicare Defined Swing Bed Hospital Unit
  • Gladwin, MI
  • NPI 1588374813
  NPD
• Edward W Sparrow Hospital Association

  dba University of Michigan Health-Sparrow Lansing

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1073588711
  NPD (past)
• Mymichigan Medical Center Alma

  • General Acute Care Hospital
  • Alma, MI
  • NPI 1023097771
  NPD (past)

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1982086492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121896",
            "telephone_number": "207-205-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48912",
            "telephone_number": "207-205-7674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 E Mount Hope Ave",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489103207",
            "country_code": "US",
            "telephone_number": "517-267-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SAMANTHA",
        "middle_name": "ANNE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ND",
            "license": "18840",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101022012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Clark, SWT
• Marsha J Clark, M.A., L.L.C.P.
• Michael R Clark, MD
• Robert C Clark, L.P.C.
• Ronald R Clark, CSW
• Alicia Clarke, LLMSW
• Nicole A Clarke, MD
• John Michael Clarkson, M.D.
• Casey Claussen, CNM
• Andrea Lashae' Clay

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.