KELLY JEANNE CLARK MD
NPI 1487806717
Family Medicine in Traverse City, MI

Q: What is Kelly Clark's NPI number?

The NPI number for Kelly Clark is 1487806717. It was assigned to this individual provider in the NPPES registry on October 17, 2008.

Q: What is Kelly Clark's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Clark was last updated on February 10, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 17, 2008PECOS EnrolledAccepts Medicare Assignment

1400 MEDICAL CAMPUS DR, TRAVERSE CITY, MI 49684(231) 935-8031(231) 935-8099 Get Directions Write a Review

NPPES record last updated: February 10, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Kelly Jeanne Clark Md NPPES

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

KELLY JEANNE CLARK MD (NPI 1487806717) is an individual family medicine provider in Traverse City, Michigan, licensed in Michigan (4301090780) and active in the NPI registry since October 2008. She is enrolled in Medicare PECOS, is affiliated with Munson Medical Center, and maintains a secondary practice location in Traverse City.

NPPES Registry Identity

NPI1487806717

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameKELLY JEANNE CLARKCredential: MD

Location Address1400 MEDICAL CAMPUS DRTraverse City, MI 49684-7823

Mailing Address1400 Medical Campus DrTraverse City, MI 49684-7823 · (231) 935-8031 · Fax (231) 935-8099

Phone(231) 935-8031

Fax(231) 935-8099

Sole ProprietorYes

Medical School CMSOtherGraduated 2007

Enumeration DateOctober 17, 2008

Last NPPES UpdateFebruary 10, 2026

NPPES CertifiedFebruary 10, 2026

✔ NPI 1487806717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MI · 4301090780

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1400 MEDICAL CAMPUS DR, Traverse City, MI 49684

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Secondary Practice Location 1

Location 11105 Sixth St Ste D6Traverse City, MI 49684-2345 · Phone (231) 935-6380 · Fax (231) 935-6920

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.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

Kelly Jeanne Clark Md 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 ID8921293531

PECOS Enrollment IDI20101110000163

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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit, 30-39 minutes 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

118 services60 patients

Established patient office or other outpatient visit, 20-29 minutes 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

80 services64 patients

Follow-up hospital inpatient care per day, typically 25 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

63 services27 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

19 services19 patients

Initial hospital inpatient care per day, typically 50 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

13 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Munson Medical Center

Acute Care Hospitals · Traverse City, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number230097

Location1105 Sixth StreetTraverse City, MI 49684 · Grand Traverse County

Emergency services Birthing friendly

Kalkaska Memorial Health Center

Critical Access Hospitals · Kalkaska, MI

OwnershipGovernment - Hospital District or Authority

CMS Certification Number231301

Location419 S CoralKalkaska, MI 49646 · Kalkaska County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49684 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

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

1 supplier12 claims1,788 services$0.03 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

1 supplier12 claims720 services$0.73 avg. paid by Medicare

Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram J7644

DME-Drugs Administered Through DME · category DG006N

1 supplier12 claims360 services$0.15 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

1 supplier12 claims12 services$23.87 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

JOSEPH N COOK D.O.

Family Medicine