JONATHAN B. CLARK CRNA
NPI 1275923781
Nurse Anesthetist, Certified Registered in Providence, RI
About Jonathan B. Clark Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JONATHAN B. CLARK CRNA (NPI 1275923781) is an individual nurse anesthetist, certified registered in Providence, Rhode Island, licensed in Rhode Island (APRN00302) and active in the NPI registry since February 2015. He is affiliated with South Shore Hospital and is a graduate of Other (2015).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jonathan B. Clark Crna is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Areas of Expertise CMS Part B claims 3
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
South Shore Hospital
Acute Care Hospitals · South Weymouth, MAMedicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PROVIDENCE, RI 02906
PROVIDENCE, RI 02906
PROVIDENCE, RI 02906
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jonathan Clark's NPI number?
The NPI number for Jonathan Clark is 1275923781. It was assigned to this individual provider in the NPPES registry on February 4, 2015.
Where is Jonathan Clark located?
Jonathan Clark practices at 164 Summit Ave, Providence, RI 02906. The listed phone number is (401) 793-4575.
What is Jonathan Clark's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Jonathan Clark enrolled in Medicare?
Yes. Jonathan Clark is registered in the Medicare PECOS enrollment system.
Is Jonathan Clark affiliated with any hospitals?
According to CMS data, Jonathan Clark is affiliated with South Shore Hospital.
When was this NPI record last updated?
The NPPES record for Jonathan Clark was last updated on September 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jonathan B. Clark, CRNA · NPI 1275923781
Nurse Anesthetist, Certified Registered physician in Providence, Rhode Island. Individual provider, active in the CMS NPPES registry since February 4, 2015.
## Identity
- **NPI:** 1275923781 (Entity type: Individual)
- **Enumerated:** February 4, 2015
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** APRN00302 (Rhode Island)
- **Sole proprietor:** No
## Practice location
- **Address:** 164 SUMMIT AVE, Providence, RI 02906-2853
- **Phone:** (401) 793-4575
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medical school:** Other, class of 2015
## Record status
- **NPPES last updated:** September 16, 2021
- **Other identifiers:** Medicaid 110106160A (MA)
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Source: [NPI Profile](https://npiprofile.com/npi/1275923781) · Data from the CMS NPPES public registry.