Victor L. Clark, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN.CRNA.0020795 Issued in OH

Practice address

410 W 10TH Ave
Columbus, OH 43210-1240

Phone

(614) 293-8487

Fax

(614) 293-8153

NPI assigned

Feb 13, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Physician Anesthesia Services, Inc.Group PAC ID 8921997230, 159 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
• Dublin Methodist Hospital Hospital, Dublin, OH, CCN 360348

Medicare enrollment (NPD)

Enrolled

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.

• Midwest Physician Anesthesia Services, Inc.

  • Anesthesiology Physician
  • Columbus, OH
  • NPI 1598703951

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Deperro Plastic Surgery, LLC

  • Plastic Surgery Physician
  • Columbus, OH
  • NPI 1134573496
  NPD (past)

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

• Ohiohealth Corporation

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1467484972
  Care Compare affiliation
• Ohiohealth Corporation

  • Clinical Medical Laboratory
  • Columbus, OH
  • NPI 1710916945

  Hospital

  Care Compare affiliation
• Ohiohealth Corporation

  • General Acute Care Hospital
  • Dublin, OH
  • NPI 1801937008
  Care Compare affiliation

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1134826944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240",
            "telephone_number": "614-293-8487",
            "fax_number": "614-293-8153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6001 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432131502",
            "country_code": "US",
            "telephone_number": "614-552-0089",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Olentangy River Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432143908",
            "country_code": "US",
            "telephone_number": "614-566-4919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "VICTOR",
        "middle_name": "L.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-13",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.0020795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Sha Clark, LISW-S
• Tikisha Clark
• Tracey Linnette Clark
• Trisha Clark, LPN
• Valerie Clark, FNP
• William Eugene Clark
• Johannah Clarke, APRN.CNP
• Kyavonna Clarke
• Robert G Clarke IV
• Simone T. Clarke, LCDC III

• Certified Registered Nurse Anesthetist in Columbus, OH
• Providers in Columbus, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.