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Deactivated NPI 1700185410 Deactivated / Inactive NPI Male Practitioner

Michael Clark

Case Manager/Care Coordinator • Cape Girardeau, MO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Michael Clark has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 21, 2011
NPI Deactivation Date February 27, 2025
Total Practice Duration ~14 Years of Practice (2011 – 2025)

Professional Overview & Biography Verified Profile Summary

Michael Clark was a registered Case Manager/Care Coordinator practicing in Cape Girardeau, MO. Throughout an active medical career spanning 14 years, Michael Clark provided care at the practice location at 20 S SPRIGG ST until profile deactivation on 2025-02-27.

Practice Location & Contact Primary Location

Practice Address

20 S Sprigg St

Cape Girardeau, MO 637036212

Telephone 5736514177
Fax 5738882369
Associated Practice Facility / Clinic
🏢 Family Counseling Center Facility NPI 1174822167

Specialty Benchmarks & Practice Insights

Comparative analytics for Case Manager/Care Coordinator in Cape Girardeau, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 8.5 Yrs
Regional Practice Density
27 Specialists

Practicing in Cape Girardeau, MO (1640 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Case Manager/Care Coordinator Primary Specialty

NUCC Taxonomy Code: 171M00000X

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Joe Neal , BS

Counselor - Addiction (Substance Use Disorder)

NPI 1003075458

Bachelor of Science

Korey Crum , LPC

Counselor - Professional

NPI 1003396540

Licensed Professional Counselor

Carl Fisher , CASAC

Counselor - Addiction (Substance Use Disorder)

NPI 1013023860
Michala Griffin

Behavior Technician

NPI 1023604675
Lauren Cornelious

Behavior Technician

NPI 1023955234
Dr. Peggy Mcmillin , PHD CSAC11

Counselor - Addiction (Substance Use Disorder)

NPI 1043343288

PHDCSAC11

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated February 27, 2025

Record deactivated on February 27, 2025

NPI Profile Active March 21, 2011

NPI status registered as active in NPPES database

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Updated Practice Location March 21, 2011

Registered at 20 S SPRIGG ST, CAPE GIRARDEAU, MO 637036212 (Tel: 5736514177)

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Updated Business Mailing Address March 21, 2011

Registered at 20 S SPRIGG ST, CAPE GIRARDEAU, MO 637036212 (Tel: 5736514177)

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Provider Name / Credentials Updated March 21, 2011

Recorded as MICHAEL CLARK

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 21, 2011

Case Manager/Care Coordinator

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Initial NPI Registration & Enumeration March 21, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1700185410
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 21, 2011
Last Update: March 21, 2011
Deactivation Date: February 27, 2025

Mailing Address

20 S Sprigg St

Cape Girardeau, MO 637036212

Phone: 5736514177

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.