JUDITH CR CLARK (NP) – Nurse Practitioner, NPI 1780682138

JUDITH CR CLARK (NP) is a healthcare provider. based in Ann arbor, Michigan. specializing in Nurse Practitioner. They hold the professional credentials NP. They hold a License No. 4704171391 (MI). The NPI Number for JUDITH CR CLARK (NP) is 1780682138

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
JUDITH CR CLARK (NP)
NPI
1780682138
Phone
(734) 936-2047
Address
3621 S STATE ST
Enumeration Date
11 July 2005
Last Update Date
20 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7349987380
Graduation Year
2002 (24 years ago)
PAC ID
6709847312
Group Practice PAC ID
3779496856
Professional Enrollment ID
I20041026000539
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for JUDITH CR CLARK (NP)

  • South State Street, Ann Arbor, Washtenaw County, Michigan, 48108-1774, United States

    700 KMS PLACE

    ANN ARBOR, MI 48108

    Phone: (734) 936-2047

    Type: Mailing

  • Briarwood Medical Group, 375, Briarwood Circle, Ann Arbor, Washtenaw County, Michigan, 48108, United States

    ANN ARBOR, MI 481081605

    Phone: (734) 998-7207

    Type: Location

  • 375 Briarwood Cir

    Ann Arbor, MI 481081605

    Phone: (734) 998-7207

    Type: Location

  • 32605 W 12 MILE RD STE 195

    FARMINGTON HILLS, MI 483343390

    Phone: (313) 306-2023

    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.

No Medicare enrollment or revalidation data available for this provider in our database.

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 48108)

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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: 3779496856View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YFL
Physical Medicine And RehabilitationMI
A N E S T H E S I O L O G YMI
Internal Medicine, Pediatric MedicineIL
-MI
Physician AssistantMI

Reviews

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Frequently asked questions

Is there an official ID for JUDITH CR CLARK (NP) in U.S. healthcare records?
The official identifier for JUDITH CR CLARK (NP) is NPI 1780682138.
Active or inactive — what applies to JUDITH CR CLARK (NP)?
You should see JUDITH CR CLARK (NP) as active in CMS-hosted NPPES data.
What area of care is associated with JUDITH CR CLARK (NP)?
JUDITH CR CLARK (NP)'s record emphasizes Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Michigan is JUDITH CR CLARK (NP) registered?
Use Ann Arbor, Michigan as the headline location for JUDITH CR CLARK (NP) here.
When was this NPI issued?
Enumeration for JUDITH CR CLARK (NP) is noted as July 11, 2005 where the registry provides it.

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