MARK W CLARK (NPI# 1154549061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154549061 |
| Entity Type | Individual |
| Full Name | MARK W CLARK |
| Credential | CRNA |
| Practice Address |
1201 First St Kennett MO 63857 |
| Mailing Address |
12661 Foxwood Pt Poplar Bluff MO 63901-7745 |
| Practice Telephone | 5738884522 |
| Mailing Telephone | 5736867622 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 087215 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912324351 | Mark Clark | Podiatrist | 2300 Coronado Rd, Pueblo, CO 81003-1840 | 2014-03-24 |
| 1710265160 | Mark Clark | Technician, Other | 6646 Highway 50, Gerald, MO 63037-2700 | 2011-08-02 |
| 1215255682 | Mark P Clark | Counselor | 11 Brandywine Dr, Cincinnati, OH 45246-3809 | 2010-05-11 |
| 1609006022 | Mark H. Clark | Pharmacist | 2901 N Dallas Parkway, Suite 420, Plano, TX 75093 | 2009-07-20 |
| 1588856827 | Mark Brian Clark | Registered Nurse | 3420 Box Elder, Evergreen, CO 80439-7841 | 2007-08-10 |
| 1720119167 | Mark Clark | Counselor | 1366 W Indian Hills Dr Unit 69, Saint George, UT 84770-1885 | 2007-03-08 |
| 1205989605 | Mark Daniel Clark | Anesthesiology | 3735 Norton Hills Rd, Norton Shores, MI 49441-4469 | 2007-01-19 |
| 1407903693 | Mark Allen Clark | Nurse Practitioner | 111 Park Hill Dr # A, Fredericksburg, VA 22401-3357 | 2007-01-03 |
| 1447352828 | Mark Wayne Clark | Dentist | G-3550 Flushing Rd, Flint, MI 48504 | 2006-09-05 |
| 1407958291 | Mark Clark | Family Medicine | 7477 S State Rd, Goodrich, MI 48438-8745 | 2006-09-02 |
| Street Address |
1201 FIRST ST |
| City | KENNETT |
| State | MO |
| Zip Code | 63857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992278139 | Fancilla Adams | Counselor | 925 State Highway V V, Kennett, MO 63857 | 2019-01-10 |
| 1962994418 | Kiana Alexis Brown | Behavior Technician | 925 Highway W, Kennett, MO 63857 | 2018-05-31 |
| 1568953636 | Doctors Health Group, Inc | Family Medicine | 1312 First Street, Kennett, MO 63857 | 2018-05-24 |
| 1003328873 | Ann Graf | Counselor | 925 Vv, Kennett, MO 63857 | 2017-11-01 |
| 1457872160 | Jessica Luster | Technician, Other | 1109 Jones St., Kennett, MO 63857 | 2017-07-03 |
| 1235669128 | Chandra Celeste Perkins-shannon | Case Manager/Care Coordinator | 925 Hwy V, Kennett, MO 63857 | 2017-06-14 |
| 1467991612 | Sarah Lobdell | Case Manager/Care Coordinator | 925 State Highway Vv, Kennett, MO 63857 | 2017-02-21 |
| 1881132900 | Brandy Rios | Community Health Worker | 935 State Hwy Vv, Kennett, MO 63857 | 2017-02-09 |
| 1295272060 | Johnny Marie Johnson | Case Manager/Care Coordinator | 925 Hwy Vv Family Counseling Center, Kennett, MO 63857 | 2017-01-31 |
| 1043756364 | Heather Bowman | Case Manager/Care Coordinator | 875 Hwy Vv, Kennett, MO 63857 | 2017-01-10 |
| Find all providers in zip 63857 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (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. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639539141 | Mallory Elizabeth Stith | Nurse Anesthetist, Certified Registered | 1301 1st St, Kennett, MO 63857-2525 | 2016-02-25 |
| 1699141903 | Justin Smith | Nurse Anesthetist, Certified Registered | 1301 1st St, Kennett, MO 63857-2525 | 2015-08-20 |
| 1992067185 | J & M Anesthesia LLC | Nurse Anesthetist, Certified Registered | 1301 1st St, Kennett, MO 63857-2525 | 2012-06-13 |
| 1114172111 | Kennett Hma Physician Management, Inc. | Nurse Anesthetist, Certified Registered | 1301 1st St, Kennett, MO 63857-2525 | 2008-11-19 |
| 1053520874 | John M Ricketts | Nurse Anesthetist, Certified Registered | 1231 1st St, Kennett, MO 63857-2527 | 2007-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285251066 | Yousra Amor | Nurse Anesthetist, Certified Registered | St Luke's Des Peres Hospital, 2345 Dougherty Ferry Rd, St Louis, MO 63122-3313 | 2020-06-29 |
| 1457970899 | William Moran | Nurse Anesthetist, Certified Registered | 910 Daffodil Ridge Dr, O Fallon, MO 63366-7760 | 2020-04-15 |
| 1437784329 | Apollo Medical Group of Lee's Summit LLC | Nurse Anesthetist, Certified Registered | 2861 Ne Independence Ave Ste 101, Lees Summit, MO 64064-2379 | 2020-03-11 |
| 1780228155 | Olde Cabin Anesthesia | Nurse Anesthetist, Certified Registered | 11525 Olde Cabin Rd Ste 101, Creve Coeur, MO 63141-7146 | 2019-10-29 |
| 1831652049 | Kristin S Turner | Nurse Anesthetist, Certified Registered | 8991 State Highway 171, Carl Junction, MO 64834-6148 | 2019-04-14 |
| 1629536271 | Cameron David Hayter | Nurse Anesthetist, Certified Registered | 1951 N Citation Ave, Springfield, MO 65802-5406 | 2019-03-03 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1548767783 | Chynna Janae Lorusso | Nurse Anesthetist, Certified Registered | 5321 Shaw Ave, Saint Louis, MO 63110-3023 | 2018-04-12 |
| 1689108839 | Todd Aaron Macdonald | Nurse Anesthetist, Certified Registered | 2119 Highlander Dr, Joplin, MO 64804-7005 | 2017-04-14 |
| 1164883468 | James Dwain Holden | Nurse Anesthetist, Certified Registered | 22888 County Road 283, Puxico, MO 63960-7338 | 2016-03-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.