BRIAN KELLY CLARK CRNA
NPI 1821059403
Nurse Anesthetist, Certified Registered in Hampton, VA
About Brian Kelly Clark Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BRIAN KELLY CLARK CRNA (NPI 1821059403) is an individual nurse anesthetist, certified registered in Hampton, Virginia, licensed in Virginia (0024165065) and active in the NPI registry since March 2006. He maintains 4 additional practice locations.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 4
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Brian Kelly Clark Crna is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
9Medicare enrollment records show Brian Clark reassigns Medicare billing to 9 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Rocky Mount, NC 27804
- Reassigned Medicare billing, North Carolina enrollment
- 87 clinicians in this Medicare group
Allentown, PA 18104
- Reassigned Medicare billing, Pennsylvania enrollment
- Medicare enrollment name: Lehigh Anesthesia Associates PC
- 102 clinicians in this Medicare group
Hazleton, PA 18201
- Reassigned Medicare billing, Pennsylvania enrollment
- Medicare enrollment name: Hazleton Anesthesia Services PC
- 81 clinicians in this Medicare group
Melville, NY 11747
- Reassigned Medicare billing, Pennsylvania enrollment
- 928 clinicians in this Medicare group
Dushore, PA 18614
- Reassigned Medicare billing, Pennsylvania and New York enrollments
- Medicare enrollment name: Guthrie Medical Group PC
- Also billed through NPI 1245246644 (New York)
- 830 clinicians in this Medicare group
Ithaca, NY 14850
- Reassigned Medicare billing, New York enrollment
- 328 clinicians in this Medicare group
Geneva, NY 14456
- Reassigned Medicare billing, New York enrollment
- 148 clinicians in this Medicare group
Syracuse, NY 13210
- Reassigned Medicare billing, New York enrollment
- 132 clinicians in this Medicare group
East Syracuse, NY 13057
- Reassigned Medicare billing, New York enrollment
- 84 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.
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.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
HAMPTON, VA 23666
HAMPTON, VA 23666
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 Brian Clark's NPI number?
The NPI number for Brian Clark is 1821059403. It was assigned to this individual provider in the NPPES registry on March 31, 2006.
Where is Brian Clark located?
Brian Clark practices at 501 Medical Dr, Hampton, VA 23666. The listed phone number is (703) 295-9360.
What is Brian Clark's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Brian Clark enrolled in Medicare?
Yes. Brian Clark is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Brian Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Brian Clark reassigns Medicare benefits to 9 organizations: Nash Hospitals Inc (Rocky Mount, NC), Lehigh Anesthesia Associates, P.C. (Allentown, PA), Hazleton Anesthesia Services, P.C. (Hazleton, PA), North American Partners In Anesthesia, Pennsylvania , LLC (Melville, NY), Guthrie Medical Group, P.C. (Dushore, PA) and 4 more organizations, listed in the Medicare section above. 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 Brian Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Brian Clark was last updated on March 8, 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.
# Brian Kelly Clark, CRNA · NPI 1821059403
Nurse Anesthetist, Certified Registered physician in Hampton, Virginia. Individual provider, active in the CMS NPPES registry since March 31, 2006.
## Identity
- **NPI:** 1821059403 (Entity type: Individual)
- **Enumerated:** March 31, 2006
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 0024165065 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 501 MEDICAL DR, Hampton, VA 23666-6080
- **Phone:** (703) 295-9360 · **Fax:** (703) 295-9369
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** 9 organizations under Medicare reassignment (form CMS-855R): Nash Hospitals Inc (NPI 1003881822, Rocky Mount, NC); Lehigh Anesthesia Associates, P.C. (NPI 1508842246, Allentown, PA); Hazleton Anesthesia Services, P.C. (NPI 1073841698, Hazleton, PA); North American Partners In Anesthesia, Pennsylvania , LLC (NPI 1639137854, Melville, NY); Guthrie Medical Group, P.C. (NPI 1487603965, Dushore, PA); and 4 more · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 8, 2022
- **Other identifiers:** Medicaid 010170699 (VA)
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Source: [NPI Profile](https://npiprofile.com/npi/1821059403) · Data from the CMS NPPES public registry.