David Clark

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

134602 Issued in KY

Practice address

4000 Kresge Way
Louisville, KY 40207-4605

Phone

(502) 897-8100

NPI assigned

Dec 18, 2020

Last updated

Mar 26, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY, FL2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ams Anesthetist Services LLCGroup PAC ID 8325298458, 149 clinicians

Capital Anesthesia Solutions of Florida II, LLCGroup PAC ID 7911323720, 327 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sacred Heart Hospital on the Emerald Coast Hospital, Miramar Beach, FL, CCN 100292

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.

• Ams Anesthetist Services LLC

  • Anesthesiology Physician
  • Pensacola, FL
  • NPI 1770834426

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Capital Anesthesia Solutions of Florida II, LLC

  • Anesthesiology Physician
  • Naples, FL
  • NPI 1891318481
  Medicare reassignment Care Compare group

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

• Ascension Sacred Heart Emerald Coast

  • General Acute Care Hospital
  • Miramar Beach, FL
  • NPI 1558391771
  Care Compare affiliation

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1699361071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7741 UPTON OXMOOR LN APT 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224453",
            "telephone_number": "334-596-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 KRESGE WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074605",
            "telephone_number": "502-897-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-18",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-148235",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "134602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda S. Clark, MS, LPCC, NCC
• Brian M Clark, O.D.
• Charles Clark Jr., PT
• Christina Blume Clark, M.D., PH.D.
• Courtney Clark
• Donald Patrick Clark Jr., PHARMD
• Eleanor Irene Clark, M.A., CCC-SLP
• Elizabeth Clark, PA-C
• Emily Anne Clark, PT
• Gary Mike Clark, L.M.F.T.

• Certified Registered Nurse Anesthetist in Louisville, KY
• Providers in Louisville, KY by specialty
• Certified Registered Nurse Anesthetist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.