Jennifer C Clark (NPI# 1912160649, PAC ID# 3375617111) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA).
| Nation Provider ID (NPI) | 1912160649 |
| PAC ID by PECOS | 3375617111 |
| Professional Enrollment ID | I20100215000622 |
| Full Name | Jennifer C Clark |
| Organization Legal Name | DESERT PEAK ANESTHESIA, LLC |
| Address |
2326 N 400 Suite 100 Tooele UT 84074-3460 |
| Phone Number | 4358430180 |
| Gender | F |
| Graduation Year | 2008 |
| Primary Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| Group Practice PAC ID | 6002884996 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 460014 | MOUNTAIN WEST MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2055 N Main St, Tooele, UT 84074-9819 | 4358433600 | DESERT PEAK ANESTHESIA, LLC |
| 2326 N 400, Suite 100, Tooele, UT 84074-3460 | 4358430180 | DESERT PEAK ANESTHESIA, LLC |
| Organization Legal Name | DESERT PEAK ANESTHESIA, LLC |
| Physicians | 8 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jeffrey D Mcgee | Certified Registered Nurse Anesthetist (crna) | Desert Peak Anesthesia, LLC | 2326 N 400, Suite 100, Tooele, UT 84074-3460 |
| Matthew A Smith | Certified Registered Nurse Anesthetist (crna) | Desert Peak Anesthesia, LLC | 2326 N 400, Suite 100, Tooele, UT 84074-3460 |
| Thomas J Green | Certified Registered Nurse Anesthetist (crna) | Desert Peak Anesthesia, LLC | 2326 N 400, Suite 100, Tooele, UT 84074-3460 |
| Annette S Proctor | Certified Registered Nurse Anesthetist (crna) | Desert Peak Anesthesia, LLC | 2326 N 400, Suite 100, Tooele, UT 84074-3460 |
| Scott S Felt | Certified Registered Nurse Anesthetist (crna) | Desert Peak Anesthesia, LLC | 2326 N 400, Suite 100, Tooele, UT 84074-3460 |
| Kyle H Jones | Certified Registered Nurse Anesthetist (crna) | Desert Peak Anesthesia, LLC | 2326 N 400, Suite 100, Tooele, UT 84074-3460 |
| Marissa A Hewitt | Certified Registered Nurse Anesthetist (crna) | Desert Peak Anesthesia, LLC | 2326 N 400, Suite 100, Tooele, UT 84074-3460 |
| Street Address |
2326 N 400 SUITE 100 |
| City | TOOELE |
| State | UT |
| Zip | 84074-3460 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jeffrey D Mcgee | Certified Registered Nurse Anesthetist (crna) | Desert Peak Anesthesia, LLC | 2326 N 400, Suite 100, Tooele, UT 84074-3460 |
| Matthew A Smith | Certified Registered Nurse Anesthetist (crna) | Desert Peak Anesthesia, LLC | 2326 N 400, Suite 100, Tooele, UT 84074-3460 |
| Thomas J Green | Certified Registered Nurse Anesthetist (crna) | Desert Peak Anesthesia, LLC | 2326 N 400, Suite 100, Tooele, UT 84074-3460 |
| Annette S Proctor | Certified Registered Nurse Anesthetist (crna) | Desert Peak Anesthesia, LLC | 2326 N 400, Suite 100, Tooele, UT 84074-3460 |
| Scott S Felt | Certified Registered Nurse Anesthetist (crna) | Desert Peak Anesthesia, LLC | 2326 N 400, Suite 100, Tooele, UT 84074-3460 |
| Kyle H Jones | Certified Registered Nurse Anesthetist (crna) | Desert Peak Anesthesia, LLC | 2326 N 400, Suite 100, Tooele, UT 84074-3460 |
| Marissa A Hewitt | Certified Registered Nurse Anesthetist (crna) | Desert Peak Anesthesia, LLC | 2326 N 400, Suite 100, Tooele, UT 84074-3460 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert Pagnani | Physical Therapy | 6727n State Hwy 36 300, Stansbury Park, UT 84074 | |
| Jennifer B Littledike | Physician Assistant | Patrick Green Md Pllc | 134 W 1180, Suite 5, Tooele, UT 84074-1483 |
| Patrick N Green | Family Medicine | Patrick Green Md Pllc | 134 W 1180, Suite 5, Tooele, UT 84074-1483 |
| Rynthia G Crosbie | Nurse Practitioner | Patrick Green Md Pllc | 134 W 1180, Suite 5, Tooele, UT 84074-1483 |
| Hilary S Seibert | Family Medicine | Patrick Green Md Pllc | 134 W 1180, Suite 5, Tooele, UT 84074-1483 |
| David K Morrill | Optometry | 102 W 1180, Suite 2, Tooele, UT 84074-1492 | |
| Alec Kitch | Family Medicine | Ihc Health Services Inc | 777 N Main St, Tooele, UT 84074-1611 |
| Shelley R Treuhaft | Nurse Practitioner | Ihc Health Services Inc | 777 N Main St, Tooele, UT 84074-1611 |
| Charles Edward Holt | Family Medicine | 280 N Main St, Tooele, UT 84074-1650 | |
| Brand P Reynolds | Nurse Practitioner | 491 N Main St, Tooele, UT 84074-1654 | |
| Find all physicians in zip 84074 | |||
| City | TOOELE |
| Zip Code | 84074 |
| Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| City + Specialty | TOOELE + CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
Please comment or provide details below to improve the information on Jennifer C Clark.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.