GREGORY SCOTT CLARK (NPI# 1528627833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528627833 |
| Entity Type | Individual |
| Full Name | GREGORY SCOTT CLARK |
| Credential | CRNA |
| Practice Address |
3333 W Deyoung St Marion IL 62959-5884 |
| Mailing Address |
262 Woodland Hill Rd Poplar Bluff MO 63901-1870 |
| Practice Telephone | 6189987000 |
| Mailing Telephone | 5737785706 |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2020-08-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 367500000X | Nurse Anesthetist, Certified Registered | 209019721 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 123868 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2 S Hospital Dr, Murphysboro, IL 629663333 | 6186843156 | 6185290529 |
| 201 S 14th St, Herrin, IL 629483631 | 6189422171 | 6183514919 |
| 405 W Jackson St, Carbondale, IL 629011462 | 6185490721 | 6185290449 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760991012 | Gregory Clark | Driver | 1091 Old South Dr, Lakeland, FL 33811 | 2017-09-28 |
| 1184758229 | Gregory Ray Clark | Physical Therapist | 3 Windsor Ct, Shawnee, OK 74804-2330 | 2007-03-14 |
| 1114064797 | Gregory Dale Clark | Dentist | 4212 Mcever Rd, Oakwood, GA 30566-2237 | 2007-01-31 |
| 1225141823 | Gregory Lynn Clark | Specialist | 11790 Sw Barnes Rd, Suite 330, Portland, OR 97225-5934 | 2006-08-16 |
| 1689608952 | Gregory D Clark | Social Worker | 118 Broadway N, Ste 810, Fargo, ND 58102-4949 | 2006-07-10 |
| 1164409728 | Gregory Clark | Counselor | 225 N Beaumont Rd, Prairie Du Chien, WI 53821-1445 | 2005-12-26 |
| 1073178851 | Gregory Clark | Student in an Organized Health Care Education/Training Program | 550 1st Ave, New York, NY 10016-6402 | 2019-05-07 |
| 1548736622 | Gregory Allen Clark | Marriage & Family Therapist | 1150 5th St Ste 270, Coralville, IA 52241-2933 | 2018-10-16 |
| 1881055911 | Gregory Scott Clark Jr. | Counselor | 1121 E Southeast Loop 323 Ste 204, Tyler, TX 75701 | 2016-03-17 |
| 1164841102 | Gregory S Clark | Physician Assistant | 8433 Harcourt Rd Ste 100, Indianapolis, IN 46260-2193 | 2014-04-07 |
| Street Address |
3333 W DEYOUNG ST |
| City | MARION |
| State | IL |
| Zip Code | 62959-5884 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922007533 | New Century Physicians of Southern Illinois Inc | Emergency Medicine | 3333 W Deyoung St, Marion, IL 62959-5884 | 2005-07-15 |
| 1538774898 | Russell Craig Arendt | Nurse Anesthetist, Certified Registered | 3333 W Deyoung St, Marion, IL 62959-5884 | 2020-09-14 |
| 1811515984 | Medcore Diagnostics LLC | Pathology | 3333 W Deyoung St, Marion, IL 62959-5884 | 2020-07-06 |
| 1942826540 | Joseph Michael Logan Oldani | Nurse Anesthetist, Certified Registered | 3333 W Deyoung St, Marion, IL 62959-5884 | 2020-06-19 |
| 1326662891 | Medcore Associates, Pllc | Pathology | 3333 W Deyoung St, Marion, IL 62959-5884 | 2020-06-01 |
| 1235779125 | Jacob Ivey | Pharmacist | 3333 W Deyoung St, Marion, IL 62959-5884 | 2020-01-08 |
| 1194297879 | Jessica Hays | Nurse Practitioner | 3333 W Deyoung St, Marion, IL 62959-5884 | 2018-12-19 |
| 1598240145 | Amy Jo Blandford | Nurse Practitioner | 3333 W Deyoung St, Marion, IL 62959-5884 | 2018-09-29 |
| 1306322136 | Joshua Richardson | Registered Nurse | 3333 W Deyoung St, Marion, IL 62959-5884 | 2018-07-15 |
| 1518478122 | Gopath Pathology Group, LLC | Pathology | 3333 W Deyoung St, Marion, IL 62959-5884 | 2017-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710513486 | Sarah Benitone | Counselor | 11264 Il-37, Marion, IL 62959 | 2020-03-13 |
| 1528609328 | Patricia E Murphy | Radiology | 4503 1/2 W Deyoung, Suite 3a, Marion, IL 62959 | 2019-10-02 |
| 1366007007 | Centerstone of Illinois, Inc | Community/Behavioral Health | 202 S Bentley St, Marion, IL 62959 | 2019-05-08 |
| 1649752064 | Sydney Seiter | Occupational Therapist | 906 Skyline Suite 100, Marion, IL 62959 | 2018-09-01 |
| 1497279848 | Brooke Alisa Osman | Licensed Practical Nurse | 11531 Sunderland Road, Marion, IL 62959 | 2017-07-27 |
| 1912436429 | Joy L. Kee | Social Worker | 509 South Bentley Street, Marion, IL 62959 | 2017-06-08 |
| 1386181170 | Susan Smothers | Counselor | 1305 West Main Street, Marion, IL 62959 | 2017-01-31 |
| 1205280922 | Harish Kempegowda | Orthopaedic Surgery | 3331 W Deyoung St Ste 201, Marion, IL 62959 | 2016-04-19 |
| 1942609227 | Casey Hill | Social Worker | 1604 W. Walnut St., Marion, IL 62959 | 2014-08-22 |
| 1306252812 | Justin M White | Chiropractor | 1603 W Kimmel, Marion, IL 62959 | 2014-07-03 |
| Find all providers in zip 62959 | ||||
| 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 |
|---|---|---|---|---|
| 1740670686 | Richard Horsey | Nurse Anesthetist, Certified Registered | 316 Converse Rd, Marion, MA 02738-1669 | 2015-01-30 |
| 1326325929 | Anesthesia Staffing Consultants of Ohio, LLC | Nurse Anesthetist, Certified Registered | 145 Baker St, Marion, OH 43302-4111 | 2011-11-10 |
| 1558494716 | Douglas White | Nurse Anesthetist, Certified Registered | 1065 Delaware Ave Ste A, Marion, OH 43302-6461 | 2007-03-14 |
| 1306992375 | Marion Surgery Center Ltd | Nurse Anesthetist, Certified Registered | 806 N. Treas, Marion, IL 62959 | 2007-01-25 |
| 1518014596 | Christopher R Whitley | Nurse Anesthetist, Certified Registered | 906 E Gregory Lane, Marion, IL 62959 | 2007-01-04 |
| 1053321935 | George E Wiggins | Nurse Anesthetist, Certified Registered | 12266 Deer Run Rd, Marion, IL 62959-8948 | 2006-08-09 |
| 1831116912 | Gasjobs of Oh, Inc. | Nurse Anesthetist, Certified Registered | 899 Christopher Dr, Marion, OH 43302-8371 | 2006-07-16 |
| 1538774898 | Russell Craig Arendt | Nurse Anesthetist, Certified Registered | 3333 W Deyoung St, Marion, IL 62959-5884 | 2020-09-14 |
| 1942826540 | Joseph Michael Logan Oldani | Nurse Anesthetist, Certified Registered | 3333 W Deyoung St, Marion, IL 62959-5884 | 2020-06-19 |
| 1639641426 | Claire D Faia | Nurse Anesthetist, Certified Registered | 441 N Wabash Ave, Marion, IN 46952-2612 | 2018-12-18 |
| Find all providers in MARION | ||||
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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.