CODY CLARK
NPI 1720442866
Nurse Anesthetist, Certified Registered in Lebanon, PA

Q: What is Cody Clark's NPI number?

The NPI number for Cody Clark is 1720442866. It was assigned to this individual provider in the NPPES registry on April 5, 2016.

Q: What is Cody 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 Cody Clark was last updated on April 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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 April 05, 2016Accepts Medicare Assignment

252 S 4TH ST, LEBANON, PA 17042(717) 270-7500(717) 228-1642 Get Directions Write a Review

NPPES record last updated: April 2, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 2, 2026, Oct 28, 2022 (2 updates tracked since 2022).

On this page

About Cody Clark NPPES

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

CODY CLARK (NPI 1720442866) is an individual nurse anesthetist, certified registered in Lebanon, Pennsylvania, licensed in Pennsylvania (RN626823) and active in the NPI registry since April 2016. He is affiliated with Wellspan Good Samaritan Hospital, maintains 4 additional practice locations, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1720442866

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameCODY CLARK

Location Address252 S 4TH STLebanon, PA 17042-6111

Mailing Address601 Memory LnYork, PA 17402-2231 · (717) 851-1405 · Fax (717) 851-6969

Phone(717) 270-7500

Fax(717) 228-1642

Sole ProprietorYes

Medical School CMSOtherGraduated 2016

Enumeration DateApril 5, 2016

Last NPPES UpdateApril 2, 20262 updates tracked since enumeration

NPPES CertifiedApril 2, 2026

✔ NPI 1720442866 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

License✔ Licensed in PA · RN626823

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.

252 S 4TH ST, Lebanon, PA 17042

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Secondary Practice Locations 4

Location 125 Monument Rd Ste 270York, PA 17403-5073 · Phone (717) 741-8250 · Fax (717) 741-8289

Location 2169 Martin AveEphrata, PA 17522-1734 · Phone (717) 733-0311 · Fax (717) 721-5861

Location 31001 S George StYork, PA 17403-3676 · Phone (717) 812-7687 · Fax (717) 851-5250

Location 455 Monument RdYork, PA 17403-5023 · Phone (717) 812-6425 · Fax (717) 851-5250

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

Cody Clark 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 ID2961793799

PECOS Enrollment IDI20160624000878

Medicare Billing Reassignment

Medicare enrollment records show Cody Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wellspan Medical Group

2.9 mi

Family Medicine

101 FAIRVIEW CIR
Lebanon, PA 17042

Reassigned Medicare billing, Pennsylvania enrollment
3,080 clinicians in this Medicare group

NPI 1639620164 (717) 279-7303

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 exam of colon using an endoscope 00812

Anesthesia for a colon examination with an endoscope is a method used to ensure comfort during the procedure. It involves administering medication to help you relax or sleep, thus reducing discomfort as the endoscope, a thin, flexible tube, is navigated through your colon.

24 services24 patients

Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope 00731

This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.

21 services21 patients

Hospital Affiliations CMS Care Compare

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

Wellspan Good Samaritan Hospital

Acute Care Hospitals · Lebanon, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number390066

Location252 South 4th StreetLebanon, PA 17042 · Lebanon County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17042 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

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$68.36 typical visit price

range $17.33 – $135.84

Typical copayment $17.09 (range $4.33 – $33.96)

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.

NABA RAJ MAINALI MD

Hospitalist

252 S 4TH ST
LEBANON, PA 17042

Lebanon County (717) 270-4876

MATTHEW JOHN YORTY

Nurse Anesthetist, Certified Registered

252 S 4TH ST
LEBANON, PA 17042

Lebanon County (717) 270-7500

LISA M HELFRICH PA-C

Physician Assistant

252 S 4TH ST, GOOD SAMARITAN HOSPITAL
LEBANON, PA 17042

Lebanon County (717) 270-7688

CLAUDIA BOHDAL

Physician Assistant

252 S 4TH ST
LEBANON, PA 17042

Lebanon County (717) 270-7500

MARCUS ALEXANDER SAUNDERS M.D.

Emergency Medicine

252 S 4TH ST
LEBANON, PA 17042

Lebanon County (717) 270-7688

DR. NINA L ELLIOTT DO

Emergency Medicine

252 S 4TH ST
LEBANON, PA 17042

Lebanon County (717) 270-7688

MRS. WANDA GARRETT PEREZ CRNA

Nurse Anesthetist, Certified Registered

252 S 4TH ST
LEBANON, PA 17042

Lebanon County (717) 270-7500

PRIYANKA SHARMA DO

Hospitalist

252 S 4TH ST
LEBANON, PA 17042

Lebanon County (717) 270-4876

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 Cody Clark's NPI number?

The NPI number for Cody Clark is 1720442866. It was assigned to this individual provider in the NPPES registry on April 5, 2016.

Where is Cody Clark located?

Cody Clark practices at 252 S 4th St, Lebanon, PA 17042. The listed phone number is (717) 270-7500.

What is Cody Clark's specialty?

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

Is Cody Clark enrolled in Medicare?

Yes. Cody Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Cody Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Cody Clark reassigns Medicare benefits to Wellspan Medical Group (Lebanon, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Cody Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Cody Clark affiliated with any hospitals?

According to CMS data, Cody Clark is affiliated with Wellspan Good Samaritan Hospital.

When was this NPI record last updated?

The NPPES record for Cody Clark was last updated on April 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.