Jennifer Clark

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R184963-9 Issued in MN

Practice address

1 Veterans Dr
Minneapolis, MN 55417-2309

Phone

(701) 866-3633

NPI assigned

Jul 28, 2010

Last updated

Jul 25, 2014By the provider in NPPES

Sex

Female

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 IL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allied Anesthesia Associates P CGroup PAC ID 0042118069, 53 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Allied Anesthesia Associates, P.C.

  • Interventional Pain Medicine Physician
  • Joliet, IL
  • NPI 1750330742
  Medicare reassignment Care Compare group NPD

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

• Silver Cross Hospital & Medical Centers

  • Rehabilitation Hospital Unit
  • New Lenox, IL
  • NPI 1003933797
  Care Compare affiliation
• Silver Cross Hospital & Medical Centers

  dba Silver Cross Hospital

  • General Acute Care Hospital
  • New Lenox, IL
  • NPI 1568553519
  Care Compare affiliation

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406246400000",
    "number": "1235443649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5853 LOGAN AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554192044",
            "telephone_number": "701-866-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VETERANS DR",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172309",
            "telephone_number": "701-866-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-28",
        "last_updated": "2014-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R184963-9",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Clark, L.AC., MSTOM
• Emily Clark
• Hailey Mae Clark, RN, BSN, CHPN, PHN
• Holly Diane Clark, LICSW
• Howard Brent Clark, M.D.
• Jennifer Anna Clark, RD, LD
• John Louis Clark, MD
• Mary Watson Clark, LICSW, LMSW
• Megan Elizabeth Clark, RN
• Mekka Clark

• Certified Registered Nurse Anesthetist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Certified Registered Nurse Anesthetist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2014; 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.