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: | -- |
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 July, 2025.