MR. GREGORY GLEN CLARK P.A.
NPI 1730235904
Anesthesiologist Assistant in Marietta, GA
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
Specialties & Licenses
Secondary Practice Locations 5
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Gregory Glen Clark P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Gregory Clark reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Marietta, GA 30060
- Reassigned Medicare billing, Georgia enrollment
- 3,885 clinicians in this Medicare group
Kennesaw, GA 30152
- Reassigned Medicare billing, Georgia enrollment
- 629 clinicians in this Medicare group
Woodstock, GA 30189
- Reassigned Medicare billing, Georgia enrollment
- Medicare enrollment name: Georgia Anesthesiologists, P.C.
- 131 clinicians in this Medicare group
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
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.
Wellstar Kennestone Regional Medical Center
Acute Care Hospitals · Marietta, GAMedicare 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.
MARIETTA, GA 30060
MARIETTA, GA 30060
MARIETTA, GA 30060
MARIETTA, GA 30060
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 enrollment system.
Which organizations bill Medicare for Gregory Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Gregory Clark reassigns Medicare benefits to 3 organizations: Wellstar Medical Group, LLC (Marietta, GA), Mak Anesthesia Holdings LLC (Kennesaw, GA) and Georgia Anesthesiologists, PC (Woodstock, GA). Each 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 Gregory Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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 4 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.
# Mr. Gregory Glen Clark, P.A. · NPI 1730235904
Anesthesiologist Assistant physician in Marietta, Georgia. Individual provider, active in the CMS NPPES registry since January 28, 2007.
## Identity
- **NPI:** 1730235904 (Entity type: Individual)
- **Enumerated:** January 28, 2007
- **Primary specialty:** Anesthesiologist Assistant · taxonomy 367H00000X
- **State license:** 1772 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 677 CHURCH ST NE, Marietta, GA 30060-1101
- **Phone:** (770) 794-0477 · **Fax:** (770) 794-3108
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Wellstar Medical Group, LLC (NPI 1083027320, Marietta, GA); Mak Anesthesia Holdings LLC (NPI 1912452939, Kennesaw, GA); Georgia Anesthesiologists, PC (NPI 1740299197, Woodstock, GA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Emory University School Of Medicine, class of 1987
## Record status
- **NPPES last updated:** June 19, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1730235904) · Data from the CMS NPPES public registry.