Jason Andrew Clark, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

00274169178 Issued in VA

Practice address

1970 Roanoke Blvd
Salem, VA 24153-6404

Phone

(540) 982-2463

Fax

(123) 456-7890

NPI assigned

Jan 24, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Anesthesia PCGroup PAC ID 7416851597, 70 clinicians

Acv IncGroup PAC ID 3870633936, 70 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lewisgale Hospital Alleghany Hospital, Low Moor, VA, CCN 490126
• Lewisgale Medical Center Hospital, Salem, VA, CCN 490048
• Carilion Medical Center Hospital, Roanoke, VA, CCN 490024

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 and National Provider Directory roles.

• Acv Inc

  • Anesthesiology Physician
  • Roanoke, VA
  • NPI 1881927259
  Medicare reassignment Care Compare group NPD
• Valley Anesthesia PC

  • Anesthesiology Physician
  • Salem, VA
  • NPI 1275587115
  Medicare reassignment Care Compare group
• Anesthesiology Consultants of Virginia, Inc

  • Anesthesiology Physician
  • Roanoke, VA
  • NPI 1225016603
  NPD (past)

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

• Carilion Medical Center

  dba Carilion Roanoke Memorial Hospital

  • General Acute Care Hospital
  • Roanoke, VA
  • NPI 1033102942
  Care Compare affiliation
• Columbia-Alleghany Regional Hospital Inc

  dba Lewisgale Hospital Alleghany

  • Psychiatric Hospital Unit
  • Low Moor, VA
  • NPI 1285932962
  Care Compare affiliation
• Columbia-Alleghany Regional Hospital Inc

  dba Lewisgale Hospital Alleghany

  • General Acute Care Hospital
  • Low Moor, VA
  • NPI 1538100029
  Care Compare affiliation
• Lewis-Gale Medical Center, LLC

  dba Lewisgale Medical Center

  • General Acute Care Hospital
  • Salem, VA
  • NPI 1619914785
  Care Compare affiliation

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

{
    "created_epoch": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1902101959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 ROANOKE BLVD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241536404",
            "telephone_number": "540-982-2463",
            "fax_number": "123-456-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 ROANOKE BLVD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241536404",
            "telephone_number": "540-982-2463",
            "fax_number": "123-456-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JASON",
        "middle_name": "ANDREW",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-24",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "00274169178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Salem
• City of Salem Schools
• Charles E Clark IV, M.D.
• David R. Clark, PA-C
• Donald Hamilton Clark III, MD
• Joe F Clark, M.D.
• Nathanael Bryant Clark, BEHAVIOR TECHNICIAN
• Stacy R Clark, PHARMD
• Emily Dale Clarke, BT
• Destinee Monique Clay, RBT

• Certified Registered Nurse Anesthetist in Salem, VA
• Providers in Salem, VA by specialty
• Certified Registered Nurse Anesthetist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.