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KELLIE MARIE CLARK MD
NPI 1619585403
Family Medicine in Middleville, MI

Active since July 17, 2020PECOS EnrolledAccepts Medicare Assignment
490 EDWARD ST, MIDDLEVILLE, MI 49333(269) 795-4434(269) 795-4271 Get Directions Write a Review

NPPES record last updated: September 11, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 11, 2024, Aug 12, 2024, Jul 12, 2024 and 2 more (5 updates tracked since 2020).

About Kellie Marie Clark Md NPPES

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

KELLIE MARIE CLARK MD (NPI 1619585403) is an individual family medicine provider in Middleville, Michigan, licensed in Michigan (4301511876) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1619585403
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameKELLIE MARIE CLARKCredential: MD
Location Address490 EDWARD STMiddleville, MI 49333-9131
Mailing Address100 Michigan St Ne # Mc845Grand Rapids, MI 49503-2560
Phone(269) 795-4434
Fax(269) 795-4271
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateJuly 17, 2020
Last NPPES UpdateSeptember 11, 20245 updates tracked since enumeration
NPPES CertifiedSeptember 11, 2024
✔ NPI 1619585403 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 · 4301511876
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.
490 EDWARD ST, Middleville, MI 49333
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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

Kellie Marie 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 ID8426459942
PECOS Enrollment IDI20240626000640
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 2

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

Corewell Health Pennock Hospital

Critical Access Hospitals · Hastings, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number231339
Location1009 W Green StHastings, MI 49058 · Barry County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49333 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.

Other Providers at the Same Location NPPES 7

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

PENNOCK HOSPITAL
Clinic/Center (Rural Health)
490 EDWARD ST
MIDDLEVILLE, MI 49333
Barry County (269) 795-4434
MS. JERINDA K SCHELL P.A.
Physician Assistant
490 EDWARD ST
MIDDLEVILLE, MI 49333
Barry County (269) 795-4434
DR. LYNDA JEANNE MARGARET SIMPSON DO
Family Medicine
490 EDWARD ST
MIDDLEVILLE, MI 49333
Barry County (269) 795-4434
PENNOCK HOSPITAL
Family Medicine
490 EDWARD ST
MIDDLEVILLE, MI 49333
Barry County (269) 795-4434
SPECTRUM HEALTH UNITED
Clinic/Center (Rural Health)
490 EDWARD ST
MIDDLEVILLE, MI 49333
Barry County (269) 795-4434
CROSSROADS COUNSELING & CONSULTATION SERVICES, LLC
Community/Behavioral Health
490 EDWARD ST
MIDDLEVILLE, MI 49333
Barry County (616) 450-4925
MATTHEW RISK GARBER MD
Family Medicine
490 EDWARD ST
MIDDLEVILLE, MI 49333
Barry County (269) 795-4434

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 Kellie Clark's NPI number?

The NPI number for Kellie Clark is 1619585403. It was assigned to this individual provider in the NPPES registry on July 17, 2020.

Where is Kellie Clark located?

Kellie Clark practices at 490 Edward St, Middleville, MI 49333. The listed phone number is (269) 795-4434.

What is Kellie Clark's specialty?

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

Is Kellie Clark enrolled in Medicare?

Yes. Kellie 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 Kellie Clark accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Kellie 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 Kellie Clark affiliated with any hospitals?

According to CMS data, Kellie Clark is affiliated with Spectrum Health and Corewell Health Pennock Hospital.

When was this NPI record last updated?

The NPPES record for Kellie Clark was last updated on September 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.