Robert Charles Clark, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

1044483 Issued in AL

Practice address

4370 W Main St
Dothan, AL 36305

Phone

(334) 793-5000

Fax

(334) 615-8428

NPI assigned

Mar 31, 2006

Last updated

Jul 25, 2011By the provider in NPPES

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 5

Medicare fee-for-service enrollment

Enrolled in AL, GA, FL3 enrollments

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tenet Florida Physician Services LLCGroup PAC ID 0345349478, 239 clinicians

Practice addresses (Care Compare)

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.

• Tenet Florida Physician Services LLC

  • Surgery Physician
  • West Palm Beach, FL
  • NPI 1659417467
  Medicare reassignment Care Compare group NPD
• Dale Medical Center

  dba Ozark Family Medical Clinic

  • Family Medicine Physician
  • Ozark, AL
  • NPI 1538275342
  Medicare reassignment NPD
• Dothan Anesthesiology Associates PC

  • Anesthesiology Physician
  • Dothan, AL
  • NPI 1013997857
  Medicare reassignment NPD
• Gut PC

  dba Digestive Health Specialist of the Southeast

  • Gastroenterology Physician
  • Dothan, AL
  • NPI 1073566006
  Medicare reassignment NPD
• Houston County Healthcare Authority

  dba Samc-Enterprise Medical Clinic

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment NPD
• Southern Alabama Surgery Center LLC

  dba Surgery Center South

  • Ambulatory Surgical Clinic/Center
  • Dothan, AL
  • NPI 1346349164

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• The Health Care Authority of the City of Eufaula

  dba Medical Center Barbour

  • Critical Access Hospital
  • Eufaula, AL
  • NPI 1730692641
  Medicare reassignment NPD
• Madison County Hospital Health Systems, Inc.

  dba Madison County Memorial Hospital

  • Critical Access Hospital
  • Madison, FL
  • NPI 1104821461
  Medicare reassignment NPD
• Wilson Anesthesia Associates LLC

  • Certified Registered Nurse Anesthetist
  • Columbus, GA
  • NPI 1104178482

  AL, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Dale Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Ozark, AL
  • NPI 1215479357
  NPD
• Dale Medical Center

  • Certified Registered Nurse Anesthetist
  • Ozark, AL
  • NPI 1700081254

  Nurse Anesthetist, Certified Registered

  NPD
• Flowers Pathology Group, LLC

  • Specialist
  • Dothan, AL
  • NPI 1518050574
  NPD

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311552000000",
    "number": "1992766703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6907",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36302",
            "telephone_number": "334-793-5000",
            "fax_number": "334-615-8428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36305",
            "telephone_number": "334-793-5000",
            "fax_number": "334-615-8428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2011-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1044483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AL",
            "identifier": "51515739",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034384600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "691173405B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051515739",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCARE",
            "identifier": "P00057714",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judy E Clardy, CRNA
• Carlos Stanford Clark II, MD
• Hunter Kavin Clark, CRNP
• Jacob David Clark, OD
• Lisa Lynn Clark, CRNA
• Kimberly Rochelle Clausell, CRNP
• Clayton L. Wright, D.M.D., P.C.
• Rebecca Lanman Clayton, LPC
• Clear Sight Optical LLC
• Jeffery Michael Cleland, O.D.

• Certified Registered Nurse Anesthetist in Dothan, AL
• Providers in Dothan, AL by specialty
• Certified Registered Nurse Anesthetist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2011; 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.