Active NPI
William N Clark, CRNA
- Certified Registered Nurse Anesthetist
- Nellis AFB, NV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 9500056
- Practice address
- 4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600 - Phone
- (702) 653-3550
- NPI assigned
- Jun 15, 2010
- Last updated
- Jun 10, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 9500056 | CA | Primary |
Addresses
Primary practice location
4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600
Mailing address
4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600
Phone (702) 653-3550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 Exempla Cir
Ncap PLLC
Lafayette, CO 80026-3370
Phone (303) 689-4000
2500 Rocky Mountain Ave
Loveland, CO 80538-9004
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9500056 | CA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Colorado Anesthesia Professionals PLLC | Current | Accepting new patients | |
| US Anesthesia Partners of Colorado Inc. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
4567 E 9th Ave
Denver, CO 80220
Phone (303) 302-2121
3702 Automation Way
Ste 103
Fort Collins, CO 80525
Phone (970) 495-6201
8000 E Maplewood Ave
Ste 120
Greenwood Village, CO 80111
10101 Ridgegate Pkwy
Lone Tree, CO 80124
Phone (720) 225-1000
2500 Rocky Mountain Ave
Loveland, CO 80538
Phone (970) 297-6425
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Anesthesiology Physician
- Fort Collins, CO
- NPI 1851389613
-
- Anesthesiology Physician
- Greenwood Village, CO
- NPI 1922365782
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Good Samaritan Medical Center
- General Acute Care Hospital
- Lafayette, CO
- NPI 1407845035
-
dba Greeley Emergency Center
- General Acute Care Hospital
- Greeley, CO
- NPI 1104262286
-
- General Acute Care Hospital
- Loveland, CO
- NPI 1750392304
-
- General Acute Care Hospital
- Greeley, CO
- NPI 1780243055
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591747200000",
"number": "1205157146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 LAS VEGAS BLVD N",
"city": "NELLIS AFB",
"state": "NV",
"postal_code": "891916600",
"telephone_number": "702-653-3550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 LAS VEGAS BLVD N",
"city": "NELLIS AFB",
"state": "NV",
"postal_code": "891916600",
"telephone_number": "702-653-3550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "WILLIAM",
"middle_name": "N",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-15",
"last_updated": "2020-06-10",
"certification_date": "2020-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CA",
"license": "9500056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Nellis AFB, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.