Mark W Clark, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Kennett, MO

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Mark W Clark, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Kennett, Missouri. He graduated from nursing school in 1984 and has 40 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Piggott Community Hospital, Rural Health Pain Management Llc, Mississippi County Hospital System and his current practice location is 1201 First St, Kennett, Missouri. You can reach out to his office (for appointments etc.) via phone at (573) 888-4522.

Mark W Clark is licensed to practice in Missouri (license number 087215) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1154549061.

Contact Information

Mark W Clark, CRNA
1201 First St,
Kennett, MO 63857
(573) 888-4522
Not Available

Map and Direction




Provider's Profile

Full NameMark W Clark
GenderMale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience40 Years
Location1201 First St, Kennett, Missouri
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mark W Clark graduated from nursing school in 1984
  NPI Data:
  • NPI Number: 1154549061
  • Provider Enumeration Date: 04/23/2007
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 9133189939
  • Enrollment ID: I20200428000863

Medical Identifiers

Medical identifiers for Mark W Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1154549061NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 087215 (Missouri)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Piggott Community HospitalPiggott, ARHospital
Great River Medical CenterBlytheville, ARHospital
Arkansas Methodist Medical CenterParagould, ARHospital
Cedar County Memorial HospitalEl dorado springs, MOHospital
St Bernards Medical CenterJonesboro, ARHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Piggott Community Hospital034514044817
Rural Health Pain Management Llc892141034118
Mississippi County Hospital System973923072313

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mark W Clark allows following entities to bill medicare on his behalf.
Entity NamePiggott Community Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1871555185
PECOS PAC ID: 0345140448
Enrollment ID: O20040113000615
Entity NameDelta Memorial Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1295767689
PECOS PAC ID: 1658262241
Enrollment ID: O20040323000890
Entity NameFive Rivers Medical Center Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376845099
PECOS PAC ID: 1456540194
Enrollment ID: O20110321000471
Entity NameMississippi County Hospital System
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1164720868
PECOS PAC ID: 9739230723
Enrollment ID: O20110819000139
Entity NameRural Health Pain Management Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1265039556
PECOS PAC ID: 8921410341
Enrollment ID: O20220121002281

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mark W Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mark W Clark, CRNA
12661 Foxwood Pt,
Poplar Bluff, MO 63901-7745

Ph: (573) 686-7622		Mark W Clark, CRNA
1201 First St,
Kennett, MO 63857

Ph: (573) 888-4522

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Kennett, MO

John M Ricketts, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 1231 1st St, Kennett, MO 63857
Phone: 573-888-4522    
Mallory Elizabeth Stith, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 1301 1st St, Kennett, MO 63857
Phone: 573-718-4038    
Justin Smith, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 1301 1st St, Kennett, MO 63857
Phone: 573-686-5550    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.