NAJM CLARK – Licensed Practical Nurse, NPI 1053767368

NAJM CLARK is a healthcare provider. based in Redford, Michigan. specializing in NURSE PRACTITIONER. They hold a License No. 31374 (SC). The NPI Number for NAJM CLARK is 1053767368

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
NAJM CLARK
NPI
1053767368
Phone
(248) 238-7614
Address
25064 CATHEDRAL
Enumeration Date
5 May 2016
Last Update Date
7 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8643347727
Graduation Year
2025 (1 year ago)
PAC ID
0648752725
Group Practice PAC ID
3971934399
Professional Enrollment ID
I20260306002605
Address ID
SC296511463GR300XXSTXX302
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness85
Years active:10State licenses:1Digital endpointsOther names

8,106 NURSE PRACTITIONER in MI

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Provider Addresses for NAJM CLARK

  • Cathedral, Redford Township, Wayne County, Michigan, 48239, United States

    REDFORD, MI 482391560

    Phone: (248) 238-7614

    Type: Mailing

  • 2 FAIRCHILD WAY

    GREENVILLE, SC 296075569

    Phone: (248) 238-7614

    Type: Mailing

  • 300 JOHN ST STE 4

    GREER, SC 296511463

    Phone: (864) 479-0280

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-03-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20260306002605INurse PractitionerSCTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48239)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3971934399View full group profile
NameSpecialtyState
Nurse PractitionerSC
Nurse PractitionerSC
Physician AssistantSC
Emergency Medicine, Family PracticeSC
Nurse PractitionerSC
Nurse PractitionerSC
Nurse PractitionerSC
Nurse PractitionerSC
Internal MedicineSC

Reviews

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Frequently asked questions

Can I cross-check NAJM CLARK using NPI 1053767368?
NPI 1053767368 belongs to NAJM CLARK; compare other details if you need extra assurance.
Is there an active status for NAJM CLARK?
For scheduling context, NAJM CLARK is shown as active in the registry.
What expertise is attributed to NAJM CLARK?
NAJM CLARK's specialty line reads Licensed Practical Nurse. Clinical services aligned with this taxonomy classification.
Is NAJM CLARK located near Redford?
NAJM CLARK currently maps to Redford, Michigan in this extract.
Can I trust this NPI listing for NAJM CLARK?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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