MR. GREGORY GLEN CLARK (P.A.) – Physician Assistant, NPI 1730235904
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,383 ANESTHESIOLOGY ASSISTANT in GA
Provider Addresses for MR. GREGORY GLEN CLARK (P.A.)
8954 Hospital Dr
Douglasville, GA 301342272
Phone: (770) 794-0477
Fax: (770) 794-3108
Type: Location
146 Bill Carruth Pkwy
Hiram, GA 301413749
Phone: (770) 794-0477
Fax: (770) 794-3108
Type: Location
2540 Windy Hill Rd SE
Marietta, GA 300678605
Phone: (770) 794-0477
Fax: (770) 794-3108
Type: Location
531 Roselane St NW
Suite 750
Marietta, GA 300606913
Phone: (770) 794-0477
Type: Location
677, Church Street Northeast, Elizabeth, Marietta, Cobb, Georgia, 30060, United States
MARIETTA, GA 300601101
Phone: (770) 794-0477
Fax: (770) 794-3108
Type: Location
Palmer Lane, Woodstock, Oxford County, Southwestern Ontario, Ontario, N4S 5R3, Canada
WOODSTOCK, GA 301883536
Phone: (770) 928-1307
Type: Mailing
531 ROSELANE ST NW STE 830
MARIETTA, GA 300606979
Phone: (770) 794-0477
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $93.
Total Amount is formed as General ($93) + Research ($0) + Ownership ($0) = $93.
Last reported payment date: 2024-05-07 • Largest payer in this snapshot: Edwards Lifesciences Corporation ($56).
Total Amount
$93
General + Research + Ownership
Payments
4
Total payment records
General Amount
$93
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Edwards Lifesciences Corporation | $56 |
| Medtronic, Inc. | $19 |
| Merck Sharp & Dohme LLC | $17 |
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: 2005-02-28
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050228000320 | I | Anesthesiology Assistant | GA | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 15 | 15 | $0 |
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 12 | 12 | $0 |
| 01922 | Anesthesia for x-ray or radiation therapy | 12 | 12 | $0 |
Insurance plans in this area (ZIP 30134)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | GA | |
| - | GA | |
| - | GA | |
| R H E U M A T O L O G Y | MI | |
| Hospitalist, Internal Medicine | GA | |
| Nurse Practitioner | TN | |
| Family Practice | GA | |
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| Hospitalist, Internal Medicine | GA |
Reviews
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