NPIMap

Individual provider Active NPI

Simone Clarke, CRNA

  • Certified Registered Nurse Anesthetist
  • Danville, PA
National Provider Identifier
1629492012
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN625807 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-4903
Phone
(570) 214-6677
NPI assigned
Feb 6, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN625807 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-4903

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 214-6677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140606001485 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911121256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6541

700 High St
Williamsport, PA 17701-3100
Phone (570) 321-1279

Hospital & facility affiliations

  • Upmc Williamsport Hospital, Williamsport, PA, CCN 390045
  • Geisinger-Bloomsburg Hospital Hospital, Bloomsburg, PA, CCN 390003
  • Geisinger Medical Center Hospital, Danville, PA, CCN 390006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jun 1, 2014 Accepting new patients
Susquehanna Physician Services Nurse Anesthetist, Certified Registered CurrentSince Feb 27, 2023 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Jun 1, 2014 Accepting new patients
Susquehanna Physician Services CurrentSince Feb 27, 2023 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

1100 Grampian Blvd
#P
Williamsport, PA 17701
Phone (570) 326-8457

700 High St
Williamsport, PA 17701
Phone (570) 321-1000

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

Organizations & group practices 5

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.

Hospital & facility affiliations 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1391644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1629492012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-214-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-214-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "SIMONE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-06",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN625807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.