Johnny F Clendenin Jr., CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

C01168 Issued in AR

Practice address

1801 W 40TH Ave
Suite 2B
Pine Bluff, AR 71603-6900

Phone

(870) 535-7457

Fax

(870) 535-2522

NPI assigned

Apr 10, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arkansas Surgical Hospital LLCGroup PAC ID 5496793390, 44 clinicians

Orthoarkansas PAGroup PAC ID 1456256031, 148 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Arkansas Surgical Hospital Hospital, No Little Rock, AR, CCN 040147

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Arkansas Surgical Hospital, LLC

  dba Arkansas Surgical Hospital Anesthesia Services

  • Anesthesiology Physician
  • North Little Rock, AR
  • NPI 1265192835
  Medicare reassignment Care Compare group NPD
• Orthoarkansas, PA

  • Specialist
  • Little Rock, AR
  • NPI 1952336869
  Medicare reassignment Care Compare group NPD
• Billins Anesthesia Inc

  • Anesthesiology Physician
  • Little Rock, AR
  • NPI 1184284291
  Medicare reassignment NPD
• Jefferson Regional Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Pine Bluff, AR
  • NPI 1205301587

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Premier Gastroenterology Associates PLLC

  • Gastroenterology Physician
  • Little Rock, AR
  • NPI 1538663729
  Medicare reassignment NPD
• Orthoarkansas, PA

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Little Rock, AR
  • NPI 1861459315
  NPD
• Premier Gastroenterology Associates PLLC

  dba Premier Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Little Rock, AR
  • NPI 1073079596
  NPD
• Barbara Lazerus Crna Ms

  • Anesthesiology Physician
  • Malvern, AR
  • NPI 1326002684
  NPD (past)
• Midstate Medical Services PA

  • Anesthesiology Physician
  • Hot Springs, AR
  • NPI 1851315501
  NPD (past)

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

• Arkansas Surgical Hospital, LLC

  • General Acute Care Hospital
  • North Little Rock, AR
  • NPI 1942260609
  Care Compare affiliation

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214265600000",
    "number": "1962465948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1272",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716131272",
            "telephone_number": "870-535-7457",
            "fax_number": "870-535-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W 40TH AVE",
            "address_2": "SUITE 2B",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036900",
            "telephone_number": "870-535-7457",
            "fax_number": "870-535-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLENDENIN",
        "first_name": "JOHNNY",
        "middle_name": "F",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2008-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C01168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145162701",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00319061",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5U558",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles A Clark, MD
• Debra Doublet Clark, PA-C
• Derwin Clark
• Michael D Clark, DDS
• Shelby Danyelle Clements, B.A
• Clifton G Roaf & Marvin Q Caudle
• Clontz Enterprises Inc (Dales Pharmacy)
• Jason B Cobb, MD
• Kay K Cogbill, MD
• Ray E Colclasure, D.D.S.

• Certified Registered Nurse Anesthetist in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.