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JONATHAN B. CLARK CRNA NPI 1275923781


NPI Information

NPI: 1275923781
Provider Name: JONATHAN B. CLARK, CRNA
Classification: Nurse Anesthetist, Certified Registered - 367500000X
Entity Type: Individual
Organization: SOUTH SUBURBAN GASTROENTEROLOGY PC Address:
164 SUMMIT AVE
PROVIDENCE, RI
ZIP 02906
Phone: (401) 793-4575
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Jonathan B. Clark, CRNA is a nurse anesthetist certified registered in Providence, RI with 9 years of experience. The provider is (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. Jonathan B. Clark, CRNA NPI is 1275923781. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

164 SUMMIT AVE
PROVIDENCE, RI
ZIP 02906-853
Phone: (401) 793-4575

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Anesthesia for procedure on lower intestine using an endoscope (HCPCS:00810)
  • Anesthesia for procedure on gastrointestinal tract using an endoscope (HCPCS:00740)
  • Anesthesia for lens surgery (HCPCS:00142)

The enumeration date for this NPI number is 2/4/2015 and was last updated on 9/16/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1367500000XNurse Anesthetist, Certified RegisteredRN277232MASSACHUSETTSNo
2367500000XNurse Anesthetist, Certified RegisteredAPRN00302RHODE ISLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1110106160AMEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.