William A Clark, PA-C
Individual provider Active NPI Physician Assistant · Holt, MI
NPI 1982605739 · NPPES record last updated Jun 5, 2015
Key facts
- NPI
- 1982605739
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 5601001772 (MI)
- Practice address
- 2380 Cedar St
Holt, MI 48842-2143 - Phone
- (517) 742-4922
- Fax
- (517) 699-2904
- NPI assigned
- Aug 2, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lansing Urgent Care PLC
Practice addresses (Care Compare)
12970 S US Hwy 27
Dewitt, MI 48820-7956
Phone (517) 999-2273
132 S Cedar St
Suite 3
Mason, MI 48854-2401
Phone (517) 999-2273
16945 Marsh Rd
Haslett, MI 48840-8948
Phone (517) 999-2273
2289 W Grand River Ave
Okemos, MI 48864-1649
Phone (517) 349-2300
320 E Jolly Rd
Lansing, MI 48910-6677
Phone (517) 999-4700
4440 W Saginaw Hwy
Lansing, MI 48917-2701
Phone (517) 327-6400
505 N Clippert St
Lansing, MI 48912-4701
Phone (517) 333-9200
886 E Saginaw Hwy
Grand Ledge, MI 48837-8410
Phone (517) 999-2273
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070322000331 | MI | Practitioner - Physician Assistant | 6800990326 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lansing Urgent Care, PLC | Past | Accepting new patients | |
| Sams Physical Therapy PC | Past | Accepting new patients | |
| Lansing Family Physicians PC | Past | Accepting new patients |
Interoperability endpoints
- williamclark@cfpmi.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601001772 | MI | Yes |
Addresses
Primary practice location
2380 Cedar St
Holt, MI 48842-2143
Mailing address
3413 Woods Edge
Okemos, MI 48864-5901
Phone (517) 349-3303
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0C36097 | Other | TRAVELERS MEDICARE | |
| 0C360971062 | Other | MI | MEDICARE |
| 0C36097 | Other | BCBS MICHIGAN |
Other providers in Holt, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.