Charles Clark

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R217337 Issued in MD

Practice address

3001 S Hanover St
Baltimore, MD 21225-1233

Phone

(410) 350-3200

NPI assigned

Jan 29, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, MD, DC3 enrollments

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medstar Medical Group II LLC 3,726 clinicians

North Calvert Anesthesiology Services LLC 62 clinicians

Carroll County Anesthesia Associates, PA 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medstar Harbor Hospital Hospital, Baltimore, MD, CCN 210034
• Medstar Franklin Square Medical Center Hospital, Rosedale, MD, CCN 210015
• Carroll Hospital Center Hospital, Westminster, MD, CCN 210033

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187

  DC, MD

  Medicare reassignment Care Compare group NPD
• North Calvert Anesthesiology Services LLC

  • Anesthesiology Physician
  • Baltimore, MD
  • NPI 1710360227

  MD

  Medicare reassignment Care Compare group NPD
• Carroll County Anesthesia Associates, PA

  • Anesthesiology Physician
  • Westminster, MD
  • NPI 1174564884

  MD

  Medicare reassignment Care Compare group
• Holy Cross Anesthesiology Associate PA

  • Anesthesiology Physician
  • Burtonsville, MD
  • NPI 1376501007

  DC

  Medicare reassignment NPD
• Lifebridge Anesthesia Associates, LLC

  • Anesthesiology Physician
  • Randallstown, MD
  • NPI 1003992868

  MD, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Medstar Medical Group Anesthesiology LLC

  • Anesthesiology Physician
  • Baltimore, MD
  • NPI 1528578333

  DC, MD

  Medicare reassignment NPD
• Mid-Maryland Anesthesia LLC

  • Anesthesiology Physician
  • Frederick, MD
  • NPI 1669866489

  MD

  Medicare reassignment NPD
• North American Partners in Anesthesia, Pennsylvania , LLC

  • Anesthesiology Physician
  • Melville, NY
  • NPI 1639137854

  Nurse Anesthetist, Certified Registered, PA

  Medicare reassignment NPD
• Medstar Medical Group II LLC

  • General Practice Physician
  • Chevy Chase, MD
  • NPI 1003284282
  Care Compare group
• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1043801061
  Care Compare group
• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1083247894
  Care Compare group
• Medstar Medical Group II LLC

  • General Practice Physician
  • White Plains, MD
  • NPI 1407559081
  Care Compare group

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

• Carroll Hospital Center, Inc.

  • General Acute Care Hospital
  • Westminster, MD
  • NPI 1912904210

  Hospital

  Care Compare affiliation
• Franklin Square Hospital Center, Inc

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1184712085

  Hospital

  Care Compare affiliation
• Harbor Hospital, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1720175623

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1265023535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 OLD WESTMINSTER RD",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211576712",
            "telephone_number": "443-974-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 S HANOVER ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212251233",
            "telephone_number": "410-350-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Innovation Dr",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174088815",
            "country_code": "US",
            "telephone_number": "717-843-8623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-29",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "PA",
            "license": "RN702962",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN702962",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R217337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ajanae Clark
• Anne Michelle Lydia Clark
• Ashley Lewis Clark, M.AC., L.AC.
• Brandon Clark
• Brooke Helen Clark
• Christina Clark, PA-C
• Colleen Clark, LCSW-C
• Crystal T Clark, M.D.
• Dayshawn Clark
• Emily Clark

• All providers in Baltimore, MD
• Certified Registered Nurse Anesthetist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.