Katherine Mary Clark, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

29557 Issued in TN

Practice address

8913 Town and Country Cir # 1013
Knoxville, TN 37923-4931

Phone

(253) 861-0739

NPI assigned

Feb 9, 2017

Sex

Female

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 WA, NC, IL3 enrollments

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Anesthesiologists SCGroup PAC ID 4183512080, 152 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rush University Medical Center Hospital, Chicago, IL, CCN 140119

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as group

Quality

0

Improvement activities

0

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.

• University Anesthesiologists SC

  • Anesthesiology Physician
  • Chicago, IL
  • NPI 1073558136

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• American Anesthesiology of North Carolina, PLLC

  • Certified Registered Nurse Anesthetist
  • Burlington, NC
  • NPI 1053677195

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Olympic Anesthesia Services, Inc

  • Anesthesiology Physician
  • Bremerton, WA
  • NPI 1275586125
  Medicare reassignment NPD
• American Anesthesiology of North Carolina, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Wake Forest, NC
  • NPI 1942248547

  Nurse Anesthetist, Certified Registered

  NPD

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

• Rush University Medical Center

  • Children's Hospital
  • Chicago, IL
  • NPI 1801908728
  Care Compare affiliation
• Rush University Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1932213600
  Care Compare affiliation

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1104364231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8913 TOWN AND COUNTRY CIR # 1013",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234931",
            "telephone_number": "253-861-0739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8913 TOWN AND COUNTRY CIR # 1013",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234931",
            "telephone_number": "253-861-0739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9205 122nd Ct NE",
            "address_2": "APT A107",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980335882",
            "country_code": "US",
            "telephone_number": "253-861-0739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATHERINE",
        "middle_name": "MARY",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-09",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "60722768",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "29557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Jarrett Clark, MS, RD, LDN
• Jessica Marie Clark, CPHT
• Jo-Ella Clark
• Julia Clark, OT
• Kamry Clark, MD
• Katherine Wilson Clark, M.S. CF-SLP
• Katlyn Clark
• Kayleigh Clark
• Linda F Clark, LPN
• Linda Lee Clark, N.P.

• Certified Registered Nurse Anesthetist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.