Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Dr. Edward Petersen Clack, DO

Individual provider Family Medicine Physician · NPI 1659629053

Dr. Edward Petersen Clack, DO is registered under Family Practice in Dayton, Ohio. Graduated from At Still University of Health Sciences, College of Osteo Med, Kirksville in 2012, 14 years ago. Practices with Shiloh Family Medicine LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
14
Trained at
At Still University of Health Sciences, College of Osteo Med, Kirksville
Licensed in
OH
In the registry since
2012
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

5900 N Main St Ste 3
Dayton, OH 45415-3198
Phone: (937) 277-9371
Fax: (937) 277-7734
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 34.011463 (OH)

Record details

NPI number1659629053
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedAugust 16, 2012
Last updated in NPPESMay 3, 2023
Certification dateMay 3, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Also practisesOSTEOPATHIC MANIPULATIVE MEDICINE
Medical schoolAT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated 2012 (14 years in practice)
Group practice Shiloh Family Medicine Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients197
Services billed 1,357 a service is one billed item, such as a visit, a test or a procedure
Average patient age73

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Payments from drug and device companies, 2025

Drug and device makers are required by federal law (the Physician Payments Sunshine Act) to report what they pay or give to clinicians, and CMS publishes the reports as Open Payments. This is the 2025 program year. A report is a record of a payment, not an allegation of anything, and many are small items such as meals. Only general payments are listed here; research payments and ownership or investment interests are reported separately by CMS and are not shown.

Food and Beverage $2,650 154 payments · a meal or drink at a meeting or visit, not a fee

Each amount is the sum of what companies reported for that kind of payment in 2025, rounded to the dollar. Not all of it is income to the clinician: a meal is not a fee, a charitable contribution goes to a charity, and a royalty or an acquisition payment is not a salary.

Check a report, or dispute one, at the source in CMS’s own tool, Open Payments. Corrections go through CMS’s dispute process. This site removes a home address on request and asks for no proof, because that is privacy; it will not remove an accurate payment report on request, because that is a statutory public disclosure.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician. Those with a page here are linked.

Colleagues at Shiloh Family Medicine LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice.

Other providers in Dayton