ANTHONY CLARK (CRNA) – Certified Registered Nurse Anesthetist, NPI 1013964089

ANTHONY CLARK (CRNA) is a healthcare provider. based in Canton, Ohio. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. KN237880 (OH). The NPI Number for ANTHONY CLARK (CRNA) is 1013964089

Main info

Male
30 Years Of Experience
Accepts Medicare Assignment
Name
ANTHONY CLARK (CRNA)
NPI
1013964089
Phone
(330) 363-7462
Address
2600 SIXTH STREET SW
Enumeration Date
27 May 2006
Last Update Date
19 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1996 (30 years ago)
PAC ID
7810022910
Group Practice PAC ID
9133019110
Professional Enrollment ID
I20100315000564
Address ID
OH447101702CA2600XSTXX400

Contacts

Secure Messaging
Anthony.Clark@direct.aultman.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness85
Years active:20State licenses:2Other namesUpdated within 12 months

3,016 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in OH

Provider Addresses for ANTHONY CLARK (CRNA)

  • 2600 SIXTH STREET SW

    OHIO HOSPITAL BASED PHYSICIAN CORP

    CANTON, OH 44710

    Phone: (330) 363-7462

    Fax: (330) 363-7679

    Type: Mailing

  • PO BOX 80690

    CANTON, OH 447080690

    Phone: (330) 363-7444

    Fax: (330) 363-7770

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2010-03-15

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
I20100315000564ICertified Registered Nurse Anesthetist (Crna)OHTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44710)

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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: 9133019110View full group profile
NameSpecialtyState
-OH
-OH
Certified Registered Nurse Anesthetist (Crna)OH
-OH
Certified Registered Nurse Anesthetist (Crna)OH
Certified Registered Nurse Anesthetist (Crna)OH
-OH
Certified Registered Nurse Anesthetist (Crna)OH
Certified Registered Nurse Anesthetist (Crna)OH
Certified Registered Nurse Anesthetist (Crna)OH

Reviews

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Frequently asked questions

How is ANTHONY CLARK (CRNA) identified in CMS data?
CMS-hosted NPPES data lists ANTHONY CLARK (CRNA) with NPI 1013964089.
Is ANTHONY CLARK (CRNA) listed as active for patients and plans?
The listing shows ANTHONY CLARK (CRNA) as active in the NPI system.
What is ANTHONY CLARK (CRNA)'s primary classification?
Certified Registered Nurse Anesthetist is the headline specialty for ANTHONY CLARK (CRNA) here. Clinical services aligned with this taxonomy classification.
What address line appears for ANTHONY CLARK (CRNA)?
ANTHONY CLARK (CRNA)'s geographic hint is Canton, Ohio in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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