David J Clark, C.R.N.A.

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

539933 Issued in TX

Practice address

1072 E Los Ebanos Blvd
Brownsville, TX 78520-9988

Phone

(956) 541-1278

Fax

(956) 541-2854

NPI assigned

Jul 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Montgomery County Memorial HospitalGroup PAC ID 9032015805, shared by 7 NPIs, 43 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Montgomery County Memorial Hospital Hospital, Red Oak, IA, CCN 161363

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dclark269052@direct.unitypoint.org
• Direct secure messaging: dclark129298@uihcdirect.org

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.

• Humboldt County Memorial Hospital

  • Emergency Medicine Physician
  • Humboldt, IA
  • NPI 1043395247
  Medicare reassignment NPD
• Humboldt County Memorial Hospital

  • Critical Access Hospital
  • Humboldt, IA
  • NPI 1194702977
  Medicare reassignment NPD
• Kossuth Regional Health Center

  • Critical Access Hospital
  • Algona, IA
  • NPI 1841361276
  Medicare reassignment NPD
• Mercy Medical Center New Hampton

  • Critical Access Hospital
  • New Hampton, IA
  • NPI 1770651515
  Medicare reassignment NPD
• Montgomery County Memorial Hospital

  • Internal Medicine Physician
  • Red Oak, IA
  • NPI 1265405310

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Montgomery County Memorial Hospital

  • Critical Access Hospital
  • Red Oak, IA
  • NPI 1376539338
  Medicare reassignment NPD
• Shelby County Chris a Myrtue Memorial Hospital

  • Critical Access Hospital
  • Harlan, IA
  • NPI 1598871469
  Medicare reassignment NPD
• St Anthony Regional Hospital and Nursing Home

  • Family Medicine Physician
  • Carroll, IA
  • NPI 1801815972
  Medicare reassignment NPD
• Greater Regional Medical Center

  • Critical Access Hospital
  • Creston, IA
  • NPI 1902805062
  Medicare reassignment
• Shelby County Chris a. Myrtue Memorial Hospital

  • Family Medicine Physician
  • Harlan, IA
  • NPI 1922184175
  Medicare reassignment
• Kossuth Regional Health Center

  • Critical Access Hospital
  • Algona, IA
  • NPI 1679644330
  NPD
• Montgomery County Memorial Hospital

  • Community/Retail Pharmacy
  • Red Oak, IA
  • NPI 1699887547
  NPD

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

• Montgomery County Memorial Hospital

  • Critical Access Hospital
  • Red Oak, IA
  • NPI 1376539338
  Care Compare affiliation

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609890607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3687",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785233687",
            "telephone_number": "956-541-1278",
            "fax_number": "956-541-2854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 E LOS EBANOS BLVD",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785209988",
            "telephone_number": "956-541-1278",
            "fax_number": "956-541-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "C.R.N.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "539933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006838903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Lee Cisneros, OD
• Romulo Cisneros III
• Yvet Linda Cisneros, MD
• City of Brownsville
• CJ Services Texas LLC
• Thomas A Clark, MD
• Claudia P. Garcia, M.D.
• Claudia Valencia Dba Alivio Home Care
• Gabriel Claudio
• Clear Imaging Spec LLC

• Certified Registered Nurse Anesthetist in Brownsville, TX
• Providers in Brownsville, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.