JERRY RANDALL CLARK MD
NPI 1992780860
Anesthesiology in Winston Salem, NC

Active since December 13, 2005PECOS EnrolledAccepts Medicare Assignment
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157(336) 716-2255 Get Directions Write a Review

NPPES record last updated: August 23, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jerry Randall Clark Md NPPES

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

JERRY RANDALL CLARK MD (NPI 1992780860) is an individual anesthesiology provider in Winston Salem, North Carolina, licensed in North Carolina (200200013) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with North Carolina Baptist Hospital, and is a graduate of Temple University School Of Medicine (1997).

NPPES Registry Identity

NPI1992780860
Entity TypeIndividualMale
Primary Taxonomy207L00000X
Provider Legal NameJERRY RANDALL CLARKCredential: MD
Location AddressMEDICAL CENTER BLVDWinston Salem, NC 27157-0001
Mailing AddressPo Box 344Winston Salem, NC 27102-0344 · (336) 716-2255
Sole ProprietorNo
Medical School CMSTemple University School Of MedicineGraduated 1997
Enumeration DateDecember 13, 2005
Last NPPES UpdateAugust 23, 2017
NPI 1992780860 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License Licensed in NC · 200200013
Definition

An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.

Also ListedAnesthesiology · Pain MedicineTaxonomy 207LP2900X · License 200200013 (NC)
MEDICAL CENTER BLVD, Winston Salem, NC 27157

Other Identifiers 10

Other050086653Rr Medicare
Other46553Partners
OtherB4294Medcost
Other7543615Aetna
MedicaidQ00012SC
Medicare PIN2299303A
Medicaid1840960000VA
Medicaid891302ENC
Other1302EBcbs
Medicare UPINH59253

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

Jerry Randall Clark Md 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 ID6608913959
PECOS Enrollment IDI20150715000215
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

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.

Insertion of artery tube for blood sampling or infusion through skin 36620
This procedure involves placing a small tube into an artery, usually in the wrist or elbow, to collect blood samples or administer medication. It's done under local anesthesia and is a common, safe practice.
18 services18 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.
17 services17 patients
Anesthesia for other procedure on upper abdomen 00790
Anesthesia for an upper abdomen procedure involves using medications to help you feel no pain during the operation. It can be general, where you're unconscious, or regional, where just the abdomen area is numbed. It ensures comfort and stillness, aiding a successful procedure.
17 services17 patients

Hospital Affiliations CMS Care Compare

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

North Carolina Baptist Hospital

Acute Care Hospitals · Winston-Salem, NC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340047
LocationMedical Center BoulevardWinston-Salem, NC 27157 · Forsyth County
Emergency services Birthing friendly

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.

Anesthesiology
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Physician Assistant (Medical)
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Physician Assistant (Medical)
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Obstetrics & Gynecology
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Internal Medicine (Hematology & Oncology)
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Hospitalist
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Nurse Anesthetist, Certified Registered
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Internal Medicine (Nephrology)
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157

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 Jerry Clark's NPI number?

The NPI number for Jerry Clark is 1992780860. It was assigned to this individual provider in the NPPES registry on December 13, 2005.

Where is Jerry Clark located?

Jerry Clark practices at Medical Center Blvd, Winston Salem, NC 27157. The listed phone number is (336) 716-2255.

What is Jerry Clark's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Jerry Clark enrolled in Medicare?

Yes. Jerry 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.

Is Jerry Clark affiliated with any hospitals?

According to CMS data, Jerry Clark is affiliated with North Carolina Baptist Hospital.

When was this NPI record last updated?

The NPPES record for Jerry Clark was last updated on August 23, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.