KATHERINE MARY CLARK (CRNA) – Certified Registered Nurse Anesthetist, NPI 1104364231
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,753 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in TN
Provider Addresses for KATHERINE MARY CLARK (CRNA)
8913 TOWN AND COUNTRY CIR # 1013
KNOXVILLE, TN 379234931
Phone: (253) 861-0739
Type: Mailing
9205 122nd Ct NE
APT A107
Kirkland, WA 980335882
Phone: (253) 861-0739
Type: Location
9205, 122nd Court Northeast, Kirkland, King County, Washington, 98033, United States
APT A107
KIRKLAND, WA 980335882
Phone: (253) 861-0739
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $112.
Total Amount is formed as General ($112) + Research ($0) + Ownership ($0) = $112.
Last reported payment date: 2023-08-02 • Largest payer in this snapshot: Avanos Medical ($98).
Total Amount
$112
General + Research + Ownership
Payments
2
Total payment records
General Amount
$112
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Avanos Medical | $98 |
| Merck Sharp & Dohme LLC | $14 |
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: 2024-11-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20170224001817 | I | Certified Registered Nurse Anesthetist (Crna) | WA | TBD |
| I20210930001311 | I | Certified Registered Nurse Anesthetist (Crna) | NC | TBD |
| I20241113003651 | I | Certified Registered Nurse Anesthetist (Crna) | IL | 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 |
|---|---|---|---|---|
| 00873 | Anesthesia for shock wave therapy for urinary system stones without water bath | 27 | 24 | $0 |
| 00914 | Anesthesia for removal of prostate including use of an endoscope | 25 | 25 | $0 |
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 18 | 18 | $0 |
| 00918 | Anesthesia for fragmenting, manipulation and/or removal of kidney stone including use of an endoscope | 14 | 14 | $0 |
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 13 | 13 | $0 |
Insurance plans in this area (ZIP 37923)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| A N E S T H E S I O L O G Y | IL | |
| A N E S T H E S I O L O G Y | MA | |
| A N E S T H E S I O L O G Y | IL | |
| A N E S T H E S I O L O G Y | IL | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| A N E S T H E S I O L O G Y | IL | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| A N E S T H E S I O L O G Y | IL |
Reviews
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