MR. LAIRD IAN CLARK (CRNA) – Certified Registered Nurse Anesthetist, NPI 1811289416

MR. LAIRD IAN CLARK (CRNA) is a healthcare provider. based in Moab, Utah. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 361242-4406 (UT). The NPI Number for MR. LAIRD IAN CLARK (CRNA) is 1811289416

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
MR. LAIRD IAN CLARK (CRNA)
NPI
1811289416
Phone
(435) 719-3510
Address
450 WILLIAMS WAY
Enumeration Date
15 May 2011
Last Update Date
24 October 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4357193500
Graduation Year
2011 (15 years ago)
PAC ID
0648445767
Group Practice PAC ID
2466361720
Professional Enrollment ID
I20150529001839
Address ID
UT845322185MO450XXWAYX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

265 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in UT

Provider Addresses for MR. LAIRD IAN CLARK (CRNA)

  • 450 WILLIAMS WAY

    MOAB, UT 845322185

    Phone: (435) 719-3510

    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)

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: 2015-05-29

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
I20150529001839ICertified Registered Nurse Anesthetist (Crna)UTTBD

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 84532)

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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: 2466361720View full group profile
NameSpecialtyState
General SurgeryWI
-UT
Orthopedic SurgeryAZ
Family PracticeUT
Family PracticeCO
Certified Registered Nurse Anesthetist (Crna)NM
Orthopedic SurgeryUT
Family Practice, Hospitalist, Family PracticeUT
General SurgeryUT
-UT

Reviews

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Frequently asked questions

What identifier follows MR. LAIRD IAN CLARK (CRNA) across health systems?
The NPI 1811289416 uniquely identifies MR. LAIRD IAN CLARK (CRNA) in U.S. healthcare data.
Is MR. LAIRD IAN CLARK (CRNA)'s NPI status active today?
Active status means MR. LAIRD IAN CLARK (CRNA)'s NPI record is not deactivated in the public file.
How should patients interpret MR. LAIRD IAN CLARK (CRNA)'s specialty?
The extract shows Certified Registered Nurse Anesthetist for MR. LAIRD IAN CLARK (CRNA). Clinical services aligned with this taxonomy classification.
Is MR. LAIRD IAN CLARK (CRNA) tied to Moab, Utah?
If you are local to Moab, Utah, MR. LAIRD IAN CLARK (CRNA) may be relevant to your search.
Why is information missing for MR. LAIRD IAN CLARK (CRNA)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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