Jonathan B. Clark is a Providence, Rhode Island based nurse anesthetist with 10 years of experience as Anesthesia Administration. He completed he graduation in 2015. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Jonathan B. Clark is APRN00302 for Anesthesia Administration in Rhode Island. his current practice location is 164 Summit Ave, Providence. Patients can reach him at 401-793-4575. Jonathan B. Clark is CRNA with specialization in Anesthesia Administration and he NPI number (Unique professional ID assigned by NPPES) is 1275923781. Jonathan B. Clark is a certified 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.
Complete Profile:
Jonathan B. Clark speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Specialization:
Anesthesia Administration
Credentials:
CRNA
Experience:
10+ years
Medical School Attended:
Other
Graduation Year:
2015
Gender:
Male
Accepts Medicare Assignment:
Yes
Practice Address:
164 Summit Ave, Providence, Rhode Island, 02906-2853
Phone:
401-793-4575
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
3476879313
Enrollment ID:
I20150311001845
NPI Number:
1275923781
NPI Enumeration Date:
04 Feb, 2015
NPI Last Update On:
16 Sep, 2021
Medical Licenses:
Nurses can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jonathan B. Clark are as mentioned below.
License Number
Specialization
State
Status
APRN00302
Anesthesia Administration
Rhode Island
Primary
RN277232
Anesthesia Administration
Massachusetts
Secondary
Hospital Affiliation:
Surgeons are affiliated to many hospitals whom they worked with in the past or are presently working with. One surgeon can be affiliated to four to five hospitals at a time.
Hospital Name (CCN)
State
Hospital Type
South Shore Hospital (220100)
South weymouth, MA
Acute Care Hospital
Group Practice:
Group practices are run by a group of physicians who share their premises and other resources. Following list states all the group name
with which Jonathan B. Clark has association with along with the number of members in that group.
Organization Name (Group PAC ID)
Members
Coastal Medical Associates (7113029257)
367
South Suburban Gastroenterology Pc (9931194412)
22
Other Medical Identifiers:
Other legacy medical identifiers associated with Jonathan B. Clark such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
110106160A
Medicaid
Massachusetts
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
333 Ricciuti Dr, Apt. 1824 Quincy, Massachusetts
Zip:
02169-6287
Phone Number:
--
Fax Number:
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Patients can reach Jonathan B. Clark at 164 Summit Ave, Providence, Rhode Island or can call to book an appointment on 401-793-4575.
Comments/ Reviews:
Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 14 April, 2025.