JONATHAN B. CLARK (NPI# 1275923781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275923781 |
| Entity Type | Individual |
| Full Name | JONATHAN B. CLARK |
| Credential | CRNA |
| Practice Address |
164 Summit Ave Providence RI 02906-2853 |
| Mailing Address |
333 Ricciuti Dr Apt. 1824 Quincy MA 02169-6287 |
| Practice Telephone | 4017934575 |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2016-02-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | APRN00302 | RI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367500000X | Nurse Anesthetist, Certified Registered | RN277232 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110106160A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790246270 | Jonathan Andrew Clark | Nurse Practitioner | 5042 12th Ave N, St Petersburg, FL 33710-6011 | 2019-03-27 |
| 1720573447 | Jonathan Clark | Specialist/Technologist | 1214 Highland Lake Cir, Decatur, GA 30033-3460 | 2018-06-25 |
| 1376033381 | Jonathan Clark | Psychologist | 150 Payson Rd, Chestnut Hill, MA 02467-3272 | 2018-05-15 |
| 1871046748 | Jonathan Clark | Acupuncturist | 1803 N Wickham Rd, Melbourne, FL 32935-8155 | 2016-07-27 |
| 1831563105 | Jonathan Michael Clark | Counselor | 1522b Gregg St, Philadelphia, PA 19115-4283 | 2015-11-23 |
| 1841696820 | Jonathan Clark | Specialist/Technologist | 14049 Scenic Hwy, Lookout Mountain, GA 30750-4100 | 2014-11-18 |
| 1932508165 | Jonathan Daniel Clark | Specialist/Technologist | 11306 County Line Rd, Madison, AL 35756-2011 | 2014-08-13 |
| 1851645717 | Jonathan Clark | Student in an Organized Health Care Education/Training Program | 206 Finley Forest Dr, Chapel Hill, NC 27517-8689 | 2012-10-30 |
| 1184682866 | Jonathan Scott Clark | Family Medicine | 1103 Dewey Ave, Poteau, OK 74953-4411 | 2006-05-03 |
| 1851740724 | Jonathan J Clark Jr. | Social Worker | 5901 E 7th St, Long Beach, CA 90822-5201 | 2016-06-10 |
| Street Address |
164 SUMMIT AVE |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02906-2853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558369512 | Josephine Salhab | Physician Assistant | 164 Summit Ave, Rm C70, Providence, RI 02906-2853 | 2005-07-13 |
| 1619519865 | Sarah Mcnerney | Physician Assistant | 164 Summit Ave, Providence, RI 02906-2853 | 2019-10-09 |
| 1831743095 | Tracy Lynn Carraggi | Nurse Practitioner | 164 Summit Ave, Providence, RI 02906-2853 | 2019-07-26 |
| 1689233975 | Nicole Parascandolo | Nurse Practitioner | 164 Summit Ave, Providence, RI 02906-2894 | 2019-06-10 |
| 1164992558 | Lisha Andrew | Dietitian, Registered | 164 Summit Ave, Providence, RI 02906-2894 | 2018-11-28 |
| 1689156242 | Monique Coley | Physician Assistant | 164 Summit Ave, Providence, RI 02906-2894 | 2018-08-30 |
| 1235615006 | Sameh Mohamed | Internal Medicine | 164 Summit Ave, Providence, RI 02906-2894 | 2018-07-16 |
| 1578058087 | Noor N Safadi | Physician Assistant | 164 Summit Ave, Providence, RI 02906-2853 | 2018-06-27 |
| 1356847172 | Heidi Jimenez | Nurse Practitioner | 164 Summit Ave, Providence, RI 02906 | 2018-04-02 |
| 1831694439 | Laura Canavan | Nurse Practitioner | 164 Summit Ave, Providence, RI 02906 | 2018-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285245175 | Birdsong Traditional Medicine, LLC | Acupuncturist | 148 Waterman St. Ground Level, Providence, RI 02906 | 2020-08-13 |
| 1881218071 | Madison Pomerantz | Psychiatry & Neurology | 345 Blackstone Boulevard, Box G-bh, Providence, RI 02906 | 2020-06-03 |
| 1316453855 | Ellen Van Ingen Darling | Psychologist | 285 Governor St Ste 250, Providence, RI 02906 | 2017-12-20 |
| 1275063919 | Marissa Martz | Psychiatry & Neurology | 345 Blackstone Blvd., Providence, RI 02906 | 2017-06-15 |
| 1235663220 | Alena Haltzman | Counselor | 223 Summit Ave, Providence, RI 02906 | 2017-04-17 |
| 1669823399 | Kathryn Fleming-ives LLC | Psychiatry & Neurology | 355 Hope St Unit 1, Providence, RI 02906 | 2016-06-23 |
| 1134573389 | Sarah E. Kramer | Psychiatry & Neurology | Butler Hospital, Adult Psychiatry Residency, 345 Blackstone Blvd, Providence, RI 02906 | 2016-04-13 |
| 1538534201 | Laura Anne Buss | Social Worker | 55 Hope St., Providence, RI 02906 | 2015-12-07 |
| 1700289360 | Tinatin Surguladze | Counselor | 205 Waterman St Suite 106, Providence, RI 02906 | 2014-09-26 |
| 1467851519 | Jamila Allouane | Social Worker | 120 Wayland Avenue Suite 2, Providence, RI 02906 | 2014-08-14 |
| Find all providers in zip 02906 | ||||
| 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 |
|---|---|---|---|---|
| 1972116523 | Sleepy Smiles LLC | Nurse Anesthetist, Certified Registered | 530 W 465 N Ste 703, Providence, UT 84332-8006 | 2020-08-24 |
| 1033359005 | Michaela J Hubbard | Nurse Anesthetist, Certified Registered | 33 Staniford St Fl 2, Providence, RI 02905-3105 | 2009-03-03 |
| 1720224140 | Alina Benoit | Nurse Anesthetist, Certified Registered | 185 Elmgrove Ave, Providence, RI 02906-4240 | 2009-01-07 |
| 1316563117 | Kate Bishop | Nurse Anesthetist, Certified Registered | 593 Eddy St, Providence, RI 02903-4923 | 2020-06-18 |
| 1821613639 | Laurie Jean Isabella | Nurse Anesthetist, Certified Registered | 593 Eddy St, Providence, RI 02903-4923 | 2020-06-08 |
| 1083246102 | Erin Kathleen Casimiro | Nurse Anesthetist, Certified Registered | 593 Eddy St, Providence, RI 02903-4923 | 2020-02-06 |
| 1871125039 | Stephanie A Wilson | Nurse Anesthetist, Certified Registered | 593 Eddy St, Providence, RI 02903-4923 | 2020-02-06 |
| 1043842313 | Brittany Williams | Nurse Anesthetist, Certified Registered | 593 Eddy St, Providence, RI 02903-4923 | 2020-02-05 |
| 1447716527 | Joanne Custodio | Nurse Anesthetist, Certified Registered | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2019-02-14 |
| 1265931265 | Vanessa Lauren Marzilli | Nurse Anesthetist, Certified Registered | 593 Eddy St, Providence, RI 02903-4923 | 2018-02-05 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02906 |
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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.