Individual provider Active NPI

Clarence Dallas Tarp, CRNA

  • Certified Registered Nurse Anesthetist
  • McAlester, OK
National Provider Identifier
1063463362
Registry record updated May 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
COO447 Issued in AR
Practice address
515 S 7TH St
McAlester, OK 74501-5915
Phone
(870) 918-4460
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X COO447 AR Primary
Certified Registered Nurse Anesthetist 367500000X R28256 AR

Addresses

Primary practice location

515 S 7TH St
McAlester, OK 74501-5915

Mailing address

3206 Caliente CT
#6184
Arlington, TX 76017-2504
Phone (870) 918-4460

Other identifiers 1

IdentifierTypeStateIssuer
103674701MedicaidAK

Other names 1

  • Clarence Tarp Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
COO447ARMDCertified Registered Nurse Anesthetist
R28256ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Mid-America Anesthesia Consultants, PC Past Accepting new patients
Anesthesiologists Associated PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Poplar Bluff Regional Medical Center Past Accepting new patients
Poplar Bluff Regional Medical Center LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Services of Benton County PA Past Accepting new patients
St John'S Regional Medical Center Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesiologists Associated PC Past Accepting new patients
St Johns Regional Medical Center Nurse Anesthetist, Certified Registered Past Accepting new patients
River Valley Anesthesia Associates, P. a. Past Accepting new patients
Ozark Anesthesia Associates, Inc. PastSince Jun 17, 2002 Accepting new patients

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369180800000",
    "number": "1063463362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3206 CALIENTE CT",
            "address_2": "#6184",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760172504",
            "telephone_number": "870-918-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S 7TH ST",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745015915",
            "telephone_number": "870-918-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARP",
        "first_name": "CLARENCE",
        "middle_name": "DALLAS",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2013-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "COO447",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "R28256",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103674701",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLARENCE",
            "last_name": "TARP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in McAlester, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.