Karly Michelle Clark

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP61446232 Issued in WA

Practice address

101 W 8TH Ave
Spokane, WA 99204-2307

Phone

(509) 747-3131

NPI assigned

Feb 10, 2020

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

Other names 1

• Karly M Mitchell Former name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Service- WashingtonGroup PAC ID 0840279758, 170 clinicians

Providence Wa Anesthesia Services, PCGroup PAC ID 9335298884, 85 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Island Hospital Hospital, Anacortes, WA, CCN 500007
• Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054

Medicare enrollment (NPD)

Enrolled

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.

• Providence Health & Service- Washington

  • Anesthesiology Physician
  • Spokane, WA
  • NPI 1508118555
  Medicare reassignment Care Compare group NPD
• Providence Wa Anesthesia Services, P.C.

  • Anesthesiology Physician
  • Everett, WA
  • NPI 1669615894
  Medicare reassignment Care Compare group NPD
• Providence Health & Services Washington

  • Pulmonary Disease Physician
  • Spokane, WA
  • NPI 1194099390
  Medicare reassignment NPD
• Providence Health & Services Washington

  • General Practice Physician
  • Spokane, WA
  • NPI 1306391446
  NPD

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

• Providence Health & Services - Wa

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1144471715
  Care Compare affiliation
• Public Hospital District No 2 Skagit County Washington

  • General Acute Care Hospital
  • Anacortes, WA
  • NPI 1710913140
  Care Compare affiliation

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1760014450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4069",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982040007",
            "telephone_number": "425-407-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 8TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042307",
            "telephone_number": "509-747-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KARLY",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP61446232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARLY",
            "last_name": "MITCHELL",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeffery Duane Clark, LICSW
• Jeffrey Clark, PHARM.D.
• Jennifer Clark, LICSW
• John Robert Clark, MD
• Karen Clark, R.PH
• Katie Clark, LMP
• Kelsey Nicole Clark, LMFT
• Kendra Rae Clark, OTR/L
• Kerry R Clark, RD
• Lavon Clark, LMFT

• Certified Registered Nurse Anesthetist in Spokane, WA
• Providers in Spokane, WA by specialty
• Certified Registered Nurse Anesthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.