William A Clark, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601001772 Issued in MI

Practice address

2380 Cedar St
Holt, MI 48842-2143

Phone

(517) 742-4922

Fax

(517) 699-2904

NPI assigned

Aug 2, 2005

Last updated

Jun 5, 2015By the provider in NPPES

Sex

Male

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 3

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, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lansing Urgent Care PLCGroup PAC ID 7214947902, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: williamclark@cfpmi.allscriptsdirect.net

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.

• Lansing Urgent Care PLC

  • Urgent Care Clinic/Center
  • Lansing, MI
  • NPI 1568688992
  Medicare reassignment Care Compare group
• Lansing Family Physicians PC

  • General Practice Physician
  • Lansing, MI
  • NPI 1023202454
  NPD (past)
• Lansing Urgent Care, PLC

  • Urgent Care Clinic/Center
  • Lansing, MI
  • NPI 1780987990
  NPD (past)
• Sams Physical Therapy PC

  • Physical Medicine & Rehabilitation Physician
  • Leslie, MI
  • NPI 1306073945
  NPD (past)

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1982605739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3413 WOODS EDGE",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488645901",
            "telephone_number": "517-349-3303",
            "fax_number": "517-349-4374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 CEDAR ST",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488422143",
            "telephone_number": "517-742-4922",
            "fax_number": "517-699-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "WILLIAM",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601001772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "0C36097",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MICHIGAN",
            "identifier": "0C36097",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0C360971062",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renu Chaturvedi, M.D.
• Children's Health and Therapy Associates, P.C.
• Chiro-Technology PC
• Aliyah Clark
• Ronisha Clark
• Kelly Coats, LLMSW
• Ashley M Cohoon, D.C
• Cole Rehabilitation Tech., Inc.
• Jessica Coleman, DC
• Patricia Collard, LMSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.