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KATHERYN ELISABETH CLARK CNM
NPI 1417489931
Advanced Practice Midwife in Grand Rapids, MI

Active since April 03, 2017PECOS EnrolledAccepts Medicare Assignment
86.44/100
CMS Quality Rating
100 MICHIGAN ST NE # MC027, GRAND RAPIDS, MI 49503(616) 391-1751(616) 391-2310 Get Directions Write a Review

NPPES record last updated: June 8, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Katheryn Elisabeth Clark Cnm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHERYN ELISABETH CLARK CNM (NPI 1417489931) is an individual advanced practice midwife in Grand Rapids, Michigan, licensed in Michigan (4704328067) and active in the NPI registry since April 2017. She is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and maintains a secondary practice location in Grand Rapids.

NPPES Registry Identity

NPI1417489931
Entity TypeIndividualFemale
Primary Taxonomy367A00000X
Provider Legal NameKATHERYN ELISABETH CLARKCredential: CNM
Location Address100 MICHIGAN ST NE # MC027Grand Rapids, MI 49503-2560
Mailing Address100 Michigan St Ne # Mc845Grand Rapids, MI 49503-2560
Phone(616) 391-1751
Fax(616) 391-2310
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateApril 3, 2017
Last NPPES UpdateJune 8, 2026
NPPES CertifiedJune 8, 2026
✔ NPI 1417489931 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAdvanced Practice MidwifePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367A00000X
License✔ Licensed in MI · 4704328067
Definition
Advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling. Source: American College of Nurse-Midwives, www.midwife.org Additional Resources: See the American College of Nurse-Midwives, www.midwife.org, for more information on Certified Nurse-Midwives, Certified Midwives, the American Midwifery Certification Board (AMCB), and licensure.
100 MICHIGAN ST NE # MC027, Grand Rapids, MI 49503
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Secondary Practice Location 1

Location 1330 Barclay Ave NE Ste 304Grand Rapids, MI 49503-2527 · Phone (616) 391-2160

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include McLaren Health Plan Community, Priority Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Katheryn Elisabeth Clark Cnm is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1557648995
PECOS Enrollment IDI20170511002198
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Spectrum Health

Acute Care Hospitals · Grand Rapids, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230038
Location100 Michigan St NEGrand Rapids, MI 49503 · Kent County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49503 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

86.44/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.93
Promoting Interoperability100
Improvement Activities40
Cost41.91

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAN MARGARET BUCHANAN CNM
Advanced Practice Midwife
100 MICHIGAN ST NE # MC027
GRAND RAPIDS, MI 49503
Kent County (616) 391-2160
MICHELLE BACKUS COLWELL M.D.
Obstetrics & Gynecology
100 MICHIGAN ST NE # MC027
GRAND RAPIDS, MI 49503
Kent County (616) 391-2160
LAUREL PATRICIA JESSUP CNM
Advanced Practice Midwife
100 MICHIGAN ST NE # MC027
GRAND RAPIDS, MI 49503
Kent County (616) 391-2160
EMILY JANE QUINEY DNP, RN, FNP-BC
Nurse Practitioner (Family)
100 MICHIGAN ST NE # MC027
GRAND RAPIDS, MI 49503
Kent County (616) 391-2160
MS. ERICKA LEE VANDER SYS CNM
Advanced Practice Midwife
100 MICHIGAN ST NE # MC027
GRAND RAPIDS, MI 49503
Kent County (616) 391-1751
DR. KATHERINE ELLEN KOWALCZYK D.O.
Obstetrics & Gynecology
100 MICHIGAN ST NE # MC027
GRAND RAPIDS, MI 49503
Kent County (616) 391-2160
AMY JO KELLY NP
Nurse Practitioner (Family)
100 MICHIGAN ST NE # MC027
GRAND RAPIDS, MI 49503
Kent County (616) 391-2160
ALI MOHSIN JAFFRY
Obstetrics & Gynecology
100 MICHIGAN ST NE # MC027
GRAND RAPIDS, MI 49503
Kent County (616) 391-2160

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Katheryn Clark's NPI number?

The NPI number for Katheryn Clark is 1417489931. It was assigned to this individual provider in the NPPES registry on April 3, 2017.

Where is Katheryn Clark located?

Katheryn Clark practices at 100 Michigan St NE # Mc027, Grand Rapids, MI 49503. The listed phone number is (616) 391-1751.

What is Katheryn Clark's specialty?

The primary specialty registered for this NPI is Advanced Practice Midwife with taxonomy code 367A00000X.

Is Katheryn Clark enrolled in Medicare?

Yes. Katheryn Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Katheryn Clark accept?

Health plans from McLaren Health Plan Community and Priority Health list Katheryn Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Katheryn Clark affiliated with any hospitals?

According to CMS data, Katheryn Clark is affiliated with Spectrum Health.

When was this NPI record last updated?

The NPPES record for Katheryn Clark was last updated on June 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 58 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.