Individual provider Active NPI

Clay Patrick

  • Certified Registered Nurse Anesthetist
  • Germantown, TN
National Provider Identifier
1902647191
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
148781 Issued in TN
Practice address
7691 Poplar Ave
Germantown, TN 38138-3904
Phone
(901) 516-6000
NPI assigned
Jun 3, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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 148781 TN Primary

Addresses

Primary practice location

7691 Poplar Ave
Germantown, TN 38138-3904

Mailing address

3915 Deerhurst St
Springdale, AR 72764-6695
Phone (870) 405-1202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN, AR3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20241112000722 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800320946 Reassigns benefits to 1 organization
I20241115002707 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800320946 Reassigns benefits to 1 organization
I20250222000133 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800320946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resource Anesthesiology Associates of TN PCGroup PAC ID 8527419092, 145 clinicians
Lifelinc Anesthesia V, P.a.Group PAC ID 8921359712, 41 clinicians

Practice addresses (Care Compare)

1265 Union Ave
Suite 201
Memphis, TN 38104-3415
Phone (901) 516-7000

4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone (662) 932-9000

4800 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (870) 936-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36533TNMDPharmacist
901922MSMDFamily Nurse Practitioner
148781TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelinc Anesthesia V, P.a. Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2025 Accepting new patients
Resource Anesthesiology Associates of TN PC Nurse Anesthetist, Certified Registered CurrentSince Aug 25, 2024 Accepting new patients

Locations

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

450 Mamaroneck Ave
Ste 201
Harrison, NY 10528
Phone (877) 476-6642

1265 Union Ave
Ste 201
Memphis, TN 38104
Phone (901) 516-7000

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

3340 Players Club Pkwy
Ste 350
Memphis, TN 38125
Phone (901) 207-2017

1300 Wesley Dr
Memphis, TN 38116
Phone (901) 516-3700

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

Organizations & group practices 2

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1902647191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 DEERHURST ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727646695",
            "telephone_number": "870-405-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7691 POPLAR AVE",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383904",
            "telephone_number": "901-516-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "CLAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "148781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.