MR. GREGORY GLEN CLARK P.A.
NPI 1730235904
Anesthesiologist Assistant in Marietta, GA

Q: What is Gregory Clark's NPI number?

The NPI number for Gregory Clark is 1730235904. It was assigned to this individual provider in the NPPES registry on January 28, 2007.

Q: What is Gregory Clark's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Q: When was this NPI record last updated?

The NPPES record for Gregory Clark was last updated on June 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 January 28, 2007Accepts Medicare Assignment

92.93/100

CMS Quality Rating

677 CHURCH ST NE, MARIETTA, GA 30060(770) 794-0477(770) 794-3108 Get Directions Write a Review

NPPES record last updated: June 19, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 14, 2022, Aug 27, 2019 (2 updates tracked since 2019).

On this page

About Mr. Gregory Glen Clark P.a. NPPES

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

MR. GREGORY GLEN CLARK P.A. (NPI 1730235904) is an individual anesthesiologist assistant in Marietta, Georgia, licensed in Georgia (1772) and active in the NPI registry since January 2007. He is affiliated with Wellstar Kennestone Regional Medical Center, maintains 5 additional practice locations, and is a graduate of Emory University School Of Medicine (1987).

NPPES Registry Identity

NPI1730235904

Entity TypeIndividualMale

Primary Taxonomy367H00000X

Provider Legal NameMR. GREGORY GLEN CLARKCredential: P.A.

Location Address677 CHURCH ST NEMarietta, GA 30060-1101

Mailing Address531 Roselane St Nw Ste 830Marietta, GA 30060-6979 · (770) 794-0477

Phone(770) 794-0477

Fax(770) 794-3108

Sole ProprietorNo

Medical School CMSEmory University School Of MedicineGraduated 1987

Enumeration DateJanuary 28, 2007

Last NPPES UpdateJune 19, 20262 updates tracked since enumeration

NPPES CertifiedJune 19, 2026

✔ NPI 1730235904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367H00000X

License✔ Licensed in GA · 1772

Definition

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

677 CHURCH ST NE, Marietta, GA 30060

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Secondary Practice Locations 5

Location 1146 Bill Carruth PkwyHiram, GA 30141-3749 · Phone (770) 794-0477 · Fax (770) 794-3108

Location 28954 Hospital DrDouglasville, GA 30134-2272 · Phone (770) 794-0477 · Fax (770) 794-3108

Location 32540 Windy Hill Rd SEMarietta, GA 30067-8605 · Phone (770) 794-0477 · Fax (770) 794-3108

Location 4531 Roselane St NW, Suite 750Marietta, GA 30060-6913 · Phone (770) 794-0477

Location 51300 Ridenour Blvd NW Ste 300Kennesaw, GA 30152-4402 · Phone (770) 702-1806

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Gregory Glen Clark P.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 ID4688627912

PECOS Enrollment IDI20050228000320

Areas of Expertise CMS Part B claims

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 x-ray or radiation therapy 01922

Anesthesia for x-ray or radiation therapy involves administering medication to help you relax or sleep during the procedure. It's used to ensure comfort, minimize movement, and reduce anxiety. The type of anesthesia used depends on the procedure and patient's health.

13 services13 patients

Hospital Affiliations CMS Care Compare

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

Wellstar Kennestone Regional Medical Center

Acute Care Hospitals · Marietta, GA

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110035

Location677 Church StreetMarietta, GA 30060 · Cobb County

Emergency services Birthing friendly

Medicare 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.

92.93/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.38

Promoting Interoperability

100

Improvement Activities

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.

JILLIAN MARIE BLALOCK DO

Emergency Medicine

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-5000

JAMIN GRAHAM MD

Student in an Organized Health Care Education/Training Program

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-5000

SAUMYA GURBANI MD, PHD

Student in an Organized Health Care Education/Training Program

677 CHURCH ST NE, ATTN: GME
MARIETTA, GA 30060

Cobb County (770) 793-7742

JULIA PATRICIA KENDRICK

Registered Nurse

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-5000

DR. HALEY PUCKETT LAWHORN MD

Student in an Organized Health Care Education/Training Program

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-5000

MRS. RHONDA KIM LEE NP-C

Registered Nurse (Wound Care)

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-7173

DEVIN HORTON CRNA

Nurse Anesthetist, Certified Registered

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 794-0477

BRITNEY ELIZABETH BECKETT

Student in an Organized Health Care Education/Training Program

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-5000

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 Gregory Clark's NPI number?

The NPI number for Gregory Clark is 1730235904. It was assigned to this individual provider in the NPPES registry on January 28, 2007.

Where is Gregory Clark located?

Gregory Clark practices at 677 Church St NE, Marietta, GA 30060. The listed phone number is (770) 794-0477.

What is Gregory Clark's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Is Gregory Clark enrolled in Medicare?

Yes. Gregory 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.

What insurance does Gregory Clark accept?

Health plans from Alliant Health Plans, Inc. list Gregory Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Gregory Clark affiliated with any hospitals?

According to CMS data, Gregory Clark is affiliated with Wellstar Kennestone Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Gregory Clark was last updated on June 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.