Individual provider Active NPI

Lori A. Clark, CRNA

  • Certified Registered Nurse Anesthetist
  • Bethlehem, PA
National Provider Identifier
1134288251
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
076891 Issued in PA
Practice address
801 Ostrum St
Bethlehem, PA 18015-1000
Phone
(610) 954-5810
Fax
(610) 954-5480
NPI assigned
Dec 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN-507355-L PA
Certified Registered Nurse Anesthetist 367500000X 076891 PA Primary

Addresses

Primary practice location

801 Ostrum St
Bethlehem, PA 18015-1000

Mailing address

PO Box 5520
Bethlehem, PA 18015-0520
Phone (610) 954-5810

Other practice location 1

1200 S Cedar Crest Blvd
Allentown, PA 18103-6202
Phone (610) 402-9099

Other identifiers 9

IdentifierTypeStateIssuer
1580856OtherPAGATEWAY
1924485OtherPAFIRST PRIORITY
11802986OtherPACAQH
104166OtherPAGEISINGER
50065227OtherPACAPITAL ADVANTAGE
9696443OtherPAAETNA
1924485OtherPAHIGHMARK
1027796550001MedicaidPA
2792759000OtherPAIBC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070118000119 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204837230 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Specialists of Bethlehem PCGroup PAC ID 1355254533, 283 clinicians

Practice addresses (Care Compare)

1736 Hamilton St
Allentown, PA 18104-5656
Phone 7067379250109

1872 St Lukes Blvd
Easton, PA 18045-5669
Phone (866) 785-8537

250 S 21St St
Easton, PA 18042-3851
Phone (610) 250-4000

421 Chew St
Allentown, PA 18102-3406
Phone (610) 954-5810

501 Cetronia Rd
Allentown, PA 18104-9569
Phone 7067379250109

521 Cetronia Rd
Allentown, PA 18104-9569
Phone (610) 954-5810

801 Ostrum St
Bethlehem, PA 18015-1065
Phone (610) 954-5810

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN-507355-LPAMDRegistered Nurse
076891PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Anesthesia Services, P. C. Nurse Anesthetist, Certified Registered CurrentSince Dec 18, 2006 Accepting new patients
Anesthesia Specialists of Bethlehem, PC Nurse Anesthetist, Certified Registered CurrentSince Dec 14, 2021 Accepting new patients

Locations

4905 W Tilghman St
Ste 250
Allentown, PA 18104
Phone (484) 866-9581

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Organizations & group practices 2

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1134288251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5520",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180150520",
            "telephone_number": "610-954-5810",
            "fax_number": "610-954-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "610-954-5810",
            "fax_number": "610-954-5480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 S Cedar Crest Blvd",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181036202",
            "country_code": "US",
            "telephone_number": "610-402-9099",
            "fax_number": "610-402-9029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LORI",
        "middle_name": "A.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2022-10-12",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN-507355-L",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "076891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1580856",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY",
            "identifier": "1924485",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11802986",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "104166",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL ADVANTAGE",
            "identifier": "50065227",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9696443",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "1924485",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027796550001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "2792759000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.