KARLY MICHELLE CLARK
NPI 1760014450
Nurse Anesthetist, Certified Registered in Spokane, WA
About Karly Michelle Clark NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KARLY MICHELLE CLARK (NPI 1760014450) is an individual nurse anesthetist, certified registered in Spokane, Washington, licensed in Washington (AP61446232) and active in the NPI registry since February 2020. She is affiliated with Island Hospital and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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
Karly Michelle 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.
Medicare Billing Reassignments
3Medicare enrollment records show Karly Clark reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Spokane, WA 99204
- Reassigned Medicare billing, Washington enrollment
- 242 clinicians in this Medicare group
Spokane, WA 99204
- Reassigned Medicare billing, Washington enrollment
- 862 clinicians in this Medicare group
Everett, WA 98201
- Reassigned Medicare billing, Washington enrollment
- Medicare enrollment name: Providence Wa Anesthesia Services, PC
- 171 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.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Island Hospital
Acute Care Hospitals · Anacortes, WAProv Sacred Hrt Med Ctr & Childs Hosp.
Acute Care Hospitals · Spokane, WAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 99204 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Karly Clark's NPI number?
The NPI number for Karly Clark is 1760014450. It was assigned to this individual provider in the NPPES registry on February 10, 2020. The provider is also known as Karly M Mitchell.
Where is Karly Clark located?
Karly Clark practices at 101 W 8th Ave, Spokane, WA 99204. The listed phone number is (509) 747-3131.
What is Karly Clark's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Karly Clark enrolled in Medicare?
Yes. Karly 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 organizations bill Medicare for Karly Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Karly Clark reassigns Medicare benefits to 3 organizations: Providence Health & Service- Washington (Spokane, WA), Providence Health & Services Washington (Spokane, WA) and Providence Wa Anesthesia Services, P.C. (Everett, WA). 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 Karly Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Karly Clark affiliated with any hospitals?
According to CMS data, Karly Clark is affiliated with Island Hospital and Prov Sacred Hrt Med Ctr & Childs Hosp..
When was this NPI record last updated?
The NPPES record for Karly Clark was last updated on January 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Karly Michelle Clark · NPI 1760014450
Nurse Anesthetist, Certified Registered physician in Spokane, Washington. Individual provider, active in the CMS NPPES registry since February 10, 2020.
## Identity
- **NPI:** 1760014450 (Entity type: Individual)
- **Enumerated:** February 10, 2020
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** AP61446232 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 101 W 8TH AVE, Spokane, WA 99204-2307
- **Phone:** (509) 747-3131
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Providence Health & Service- Washington (NPI 1508118555, Spokane, WA); Providence Health & Services Washington (NPI 1194099390, Spokane, WA); Providence Wa Anesthesia Services, P.C. (NPI 1669615894, Everett, WA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** January 30, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1760014450) · Data from the CMS NPPES public registry.