JON ALBERT CLARK C.R.N.A.
NPI 1285675702
Nurse Anesthetist, Certified Registered in Greenville, SC

Q: What is Jon Clark's NPI number?

The NPI number for Jon Clark is 1285675702. It was assigned to this individual provider in the NPPES registry on June 8, 2006.

Q: What is Jon Clark's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Q: When was this NPI record last updated?

The NPPES record for Jon Clark was last updated on January 3, 2022. 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.

Active since June 08, 2006Accepts Medicare Assignment

7 INDEPENDENCE PT STE 300, GREENVILLE, SC 29615(864) 522-3700(864) 522-3705 Get Directions Write a Review

NPPES record last updated: January 3, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 3, 2022, Sep 13, 2018 (2 updates tracked since 2018).

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About Jon Albert Clark C.r.n.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JON ALBERT CLARK C.R.N.A. (NPI 1285675702) is an individual nurse anesthetist, certified registered in Greenville, South Carolina, licensed in South Carolina (22193) and active in the NPI registry since June 2006. He is affiliated with Grand Strand Regional Medical Center and is a graduate of Other (1998).

NPPES Registry Identity

NPI1285675702

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameJON ALBERT CLARKCredential: C.R.N.A.

Location Address7 INDEPENDENCE PT STE 300Greenville, SC 29615-4569

Mailing Address300 E Mcbee Ave Fl 4Greenville, SC 29601-2842 · (864) 522-8603

Phone(864) 522-3700

Fax(864) 522-3705

Sole ProprietorNo

Medical School CMSOtherGraduated 1998

Enumeration DateJune 8, 2006

Last NPPES UpdateJanuary 3, 20222 updates tracked since enumeration

NPPES CertifiedJanuary 3, 2022

✔ NPI 1285675702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

Licenses✔ Licensed in SC · 22193✔ Licensed in MI · 4704263474

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

7 INDEPENDENCE PT STE 300, Greenville, SC 29615

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jon Albert Clark C.r.n.a. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5799740833

PECOS Enrollment IDI20181025002765

Medicare Billing Reassignments

Medicare enrollment records show Jon Clark reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Prisma Health University Medical Group

0.8 mi

Internal Medicine

1025 VERDAE BLVD, SUITE A
Greenville, SC 29607

Reassigned Medicare billing, South Carolina enrollment
3,281 clinicians in this Medicare group

NPI 1083787006 (864) 242-4683

Prisma Health-Upstate

0.8 mi

Sleep Disorder Diagnostic

1025 VERDAE BLVD, SUITE D
Greenville, SC 29607

Reassigned Medicare billing, South Carolina enrollment
413 clinicians in this Medicare group

NPI 1275086431 (864) 455-7743

Atlantic Coast Anesthesia Services P.C.

213 mi

Anesthesiology

809 82ND PKWY
Myrtle Beach, SC 29572

Reassigned Medicare billing, South Carolina enrollment
Medicare enrollment name: Atlantic Coast Anesthesia Services PC
258 clinicians in this Medicare group

NPI 1932641313 (843) 692-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

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.

Anesthesia for other procedure on upper abdomen 00790

Anesthesia for an upper abdomen procedure involves using medications to help you feel no pain during the operation. It can be general, where you're unconscious, or regional, where just the abdomen area is numbed. It ensures comfort and stillness, aiding a successful procedure.

13 services13 patients

Anesthesia for extensive surgery on spine 00670

Anesthesia for extensive spine surgery involves medication to block pain and make you unconscious during the procedure. It ensures comfort and prevents movement. Two types may be used: general (you sleep) or regional (numbs a large area). The choice depends on the surgery specifics and your health.

12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Grand Strand Regional Medical Center

Acute Care Hospitals · Myrtle Beach, SC

3/5 CMS rating

OwnershipProprietary

CMS Certification Number420085

Location809 82nd ParkwayMyrtle Beach, SC 29572 · Horry County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29615 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$124.04 typical visit price

range $53.57 – $163.84

Typical copayment $31.01 (range $13.39 – $40.96)

Most-billed visit code 99204

Established Patient

$67.12 typical visit price

range $16.96 – $133.52

Typical copayment $16.78 (range $4.24 – $33.38)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

PAUL DEREK STREET CRNA

Nurse Anesthetist, Certified Registered