Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacob Nicholas Clark, PA-C

Individual provider Physician Assistant · NPI 1972210920

Jacob Nicholas Clark, PA-C is a Physician Assistant in Lansing, Michigan. Qualified in 2022, 4 years ago. Practices with Edward W Sparrow Hospital Association, a 694-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
4
Licensed in
MI
In the registry since
2022
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1140 E Michigan Ave Ste 400
Lansing, MI 48912-1806
Phone: (517) 364-9650
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601011462 (MI)

Record details

NPI number1972210920
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedOctober 31, 2022
Last updated in NPPESMarch 25, 2026
Certification dateMarch 25, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Edward W Sparrow Hospital Association — 694 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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