Clayton Michael Clark

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP143683 Issued in TX

Practice address

307 Trent Dr
Durham, NC 27710-3038

Phone

(919) 684-3786

NPI assigned

Jun 5, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Group practices

Olney-Hamilton Hospital DistrictGroup PAC ID 9133029077, shared by 10 NPIs, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hamilton Hospital Hospital, Olney, TX, CCN 451354

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Emergenchealth PLLC

  • Anesthesiology Physician
  • Fort Worth, TX
  • NPI 1467970897

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Northstar Anesthesia II PA

  • Anesthesiology Physician
  • Burleson, TX
  • NPI 1477066405

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Northstar Anesthesia III PA

  • Anesthesiology Physician
  • Corpus Christi, TX
  • NPI 1356968952

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Olney Hamilton Hospital District

  • Nurse Practitioner
  • Olney, TX
  • NPI 1801158787

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Olney-Hamilton Hospital District

  • Critical Access Hospital
  • Olney, TX
  • NPI 1134137466
  Medicare reassignment NPD
• Youngs Professional Services LLC

  • Certified Registered Nurse Anesthetist
  • New Iberia, LA
  • NPI 1922178599

  Nurse Anesthetist, Certified Registered, TX

  Medicare reassignment NPD
• Olney-Hamilton Hospital District

  • Skilled Nursing Facility
  • Richardson, TX
  • NPI 1568849750
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Olney-Hamilton Hospital District

  • Critical Access Hospital
  • Olney, TX
  • NPI 1134137466
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1013575844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 IDA ST APT K",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 TRENT DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277103038",
            "telephone_number": "919-684-3786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CLAYTON",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "275012",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP143683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annette Aldridge Clark, CPNP
• Anthony Ronald Clark, OD
• Brandy Hunter Clark, PMHNP-BC
• Brittiany L Clark
• Caitlin Marie Clark, FNP
• David James Clark, D.C.
• Demetrice Clark, OD
• Deshya Lynise Clark
• Douglas Clark, M.D.
• Isabel Anna Clark, MD

• Certified Registered Nurse Anesthetist in Durham, NC
• Providers in Durham, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.