Randall Clark, MD
NPI 1063573319 · Family Medicine Physician · Grandville, MI
Enrolled with Medicare as Practitioner - Family Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Randall Clark, MD is a Family Medicine Physician provider in Grandville, MI (NPI 1063573319).
Provider details
- NPI number
- 1063573319
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- RC050413 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-12-12
- Last updated
- 2025-07-18
- Certified
- 2025-07-18
Frequently asked questions
- What is Randall Clark's NPI number?
- Randall Clark's National Provider Identifier (NPI) is 1063573319, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Randall Clark's specialty?
- Randall Clark is listed in the NPPES registry with a primary specialty of Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Randall Clark located?
- Randall Clark's practice location on file with NPPES is 3980 Chicago Dr Sw Ste 200, Grandville, MI 49418-1392.
- What is Randall Clark's phone number?
- The practice phone number listed in the NPPES registry for Randall Clark is (616) 381-5181.
- Does Randall Clark accept Medicare?
- Randall Clark is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Randall Clark's NPI active?
- Yes — Randall Clark's NPI (1063573319) is active in the NPPES registry as of the last update on 2025-07-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.