Clarence L. Nicodemus, PHD DO
Neuromusculoskeletal Medicine & OMM Physician · East Lansing, MI
Clarence L. Nicodemus, PHD DO is a neuromusculoskeletal medicine & omm physician with a practice address in East Lansing, Michigan, and NPI 1063690535, issued on Feb 6, 2008. Check the license (Michigan 5101016107, as entered in NPPES) with the Michigan board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Clarence L. Nicodemus
- Credential
- PHD DO
- Primary taxonomy
- Neuromusculoskeletal Medicine & OMM Physician 204D00000X
- License number
- 5101016107 MI
Self-reported in NPPES; status is on the state search - Practice location
- 4660 S Hagadorn RD, East Lansing, MI 48823
- Phone
- (517) 432-6144
- Enumerated
- Feb 6, 2008
- Record last updated
- Jun 26, 2023
- Fax
- (517) 432-6150
- Medicaid ID
- 1063690535 MI
- Medicare enrollment
- Enrolled (PECOS I20160923000188); accepts Medicare assignment
- Medical or professional school
- Michigan State University College Of Osteopathic Medicine, 2000
- Entity
- Type 1 · individual
Also registered at 4660 S Hagadorn RD
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Khalid Almutairi, M.D, MS.C, FRCSCPlastic Surgery Physician1508116914
- Allison Azamtarrahian, LMSWClinical Social Worker1942752258
- Harvey Bumpers, M.D.Surgery Physician1538168463
- Vincent Cipolla, D.ONeuromusculoskeletal Medicine & OMM Physician1922043389
- Thomas Coker, BS, RDRegistered Dietitian1396025458
- Miranda Cristales, P.A.-C.Surgical Physician Assistant1508023151
Verify Clarence L. Nicodemus in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Michigan board licenses this profession
Search for license 5101016107Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Bills Medicare through one group practice
- Msu Health Care Inc.East Lansing, MI
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through) (data.cms.gov).
30 neuromusculoskeletal medicine & omm physician records list a practice address in East Lansing
They are 30 of the 2,305 NPPES records with a practice address in East Lansing, and 76 neuromusculoskeletal medicine & omm physician records in Michigan.
All 30 in East Lansing → All 76 in Michigan → Every provider in East Lansing →
Other neuromusculoskeletal medicine & omm physician records in Michigan
- Bashar Abou-Rass, M.D.Bloomfield, MI1477845618
- Javier Baca, DOEast Lansing, MI1366291510
- Nathan Barnhurst, DOEast Lansing, MI1689297756
- Theodore Batzer, MDManistee, MI1336131606
- Lynn Beals, D.O.Ann Arbor, MI1477551539
- Mark Beard, DONovi, MI1003070723
- Peter Blakemore, DOEast Lansing, MI1821251208
- Mark Braden, DOGrand Rapids, MI1912490905
- Brittany Breitzke, DOEast Lansing, MI1164942843
- Sidney Broder, M.D.Grand Blanc, MI1851465025
Common questions
What is Clarence L. Nicodemus, PHD DO's NPI number?
Clarence L. Nicodemus, PHD DO's National Provider Identifier (NPI) is 1063690535, issued on Feb 6, 2008. An NPI identifies a provider in billing; it is not a license.
Where is Clarence L. Nicodemus, PHD DO located?
The NPPES record lists a practice address at 4660 S Hagadorn RD, East Lansing, MI, 48823. Phone: (517) 432-6144. Providers update this record themselves, so call before visiting.
How can I verify Clarence L. Nicodemus, PHD DO's license?
NPPES lists Michigan license number 5101016107, as entered by the provider. Search the Michigan board that licenses this profession; the NPPES record confirms identity only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.