MR. CASEY RYAN CLARK (CRNA) – Certified Registered Nurse Anesthetist, NPI 1174534085

MR. CASEY RYAN CLARK (CRNA) is a healthcare provider. based in Athens, Alabama. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 1-104686 (AL). The NPI Number for MR. CASEY RYAN CLARK (CRNA) is 1174534085

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
MR. CASEY RYAN CLARK (CRNA)
NPI
1174534085
Phone
(256) 206-2081
Address
22234 KENNEMER LN
Enumeration Date
10 August 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2562658120
Graduation Year
2005 (21 years ago)
PAC ID
5395753487
Group Practice PAC ID
7315990751
Professional Enrollment ID
I20060331000148
Address ID
AL358013784HU245XXSEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,625 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in AL

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Provider Addresses for MR. CASEY RYAN CLARK (CRNA)

  • 22234, Kennemer Lane, Canebrake, Athens, Limestone County, Alabama, 35613, United States

    ATHENS, AL 356138162

    Phone: (256) 206-2081

    Fax: (256) 771-5972

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $94.

Total Amount is formed as General ($94) + Research ($0) + Ownership ($0) = $94.

Last reported payment date: 2024-01-25 • Largest payer in this snapshot: ConvaTec Inc. ($47).

Total Amount

$94

General + Research + Ownership

Payments

5

Total payment records

General Amount

$94

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-25

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-03-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060331000148ICertified Registered Nurse Anesthetist (Crna)ALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00670Anesthesia for extensive surgery on spine5954$0
00630Anesthesia for other procedure on lower spine1818$0
View full utilization report →

Insurance plans in this area (ZIP 35613)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7315990751View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)AL
Certified Registered Nurse Anesthetist (Crna)WA
Certified Registered Nurse Anesthetist (Crna)AL
-AL
Certified Registered Nurse Anesthetist (Crna)AL
Certified Registered Nurse Anesthetist (Crna)AL
Certified Registered Nurse Anesthetist (Crna)AL
Certified Registered Nurse Anesthetist (Crna)AL
Certified Registered Nurse Anesthetist (Crna)GA
Certified Registered Nurse Anesthetist (Crna)AL

Reviews

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Frequently asked questions

Can I cross-check MR. CASEY RYAN CLARK (CRNA) using NPI 1174534085?
NPI 1174534085 belongs to MR. CASEY RYAN CLARK (CRNA); compare other details if you need extra assurance.
Is MR. CASEY RYAN CLARK (CRNA) still an active registrant?
MR. CASEY RYAN CLARK (CRNA) carries an active NPI according to the public dataset.
What expertise is attributed to MR. CASEY RYAN CLARK (CRNA)?
MR. CASEY RYAN CLARK (CRNA)'s specialty line reads Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What locale is associated with MR. CASEY RYAN CLARK (CRNA)?
Directory geography for MR. CASEY RYAN CLARK (CRNA) centers on Athens, Alabama.
When was this NPI issued?
Enumeration for MR. CASEY RYAN CLARK (CRNA) is noted as August 10, 2006 where the registry provides it.

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