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Active NPI 1063493468 Individual Practitioner Male Practitioner

Gary D Clark , CRNA

Registered Nurse • Bridgeton, MO

Professional Overview & Biography Verified Profile Summary

Gary Clark, CRNA is a registered healthcare professional specializing in Registered Nurse in Bridgeton, MO. Practice services are available at 12303 DEPAUL DRIVE under active NPI credentials.

Frequently performed procedures and clinical services include anesthesia for procedure on large bowel using an endoscope, anesthesia for procedure on esophagus, stomach, and/or upper small bowel using an endoscope, anesthesia for exam of colon using an endoscope. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

12303 Depaul Drive

Bridgeton, MO 63044

Telephone 3143447049
Fax 3143447073
Associated Practice Facility / Clinic
🏢 William Wang Llc Facility NPI 1336235308

Specialty Benchmarks & Practice Insights

Comparative analytics for Registered Nurse in Bridgeton, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 34.5 Yrs
State Avg: 9.5 Yrs
Regional Practice Density
22 Specialists

Practicing in Bridgeton, MO (1634 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
79.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2020)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
00811 Anesthesia for procedure on large bowel using an endoscope
11 11 $679.00 $136.16

Medical Specialties & State Licenses

Registered Nurse Primary Specialty

NUCC Taxonomy Code: 163W00000X

State License MO RN057425

(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.

Nurse Anesthetist, Certified Registered

NUCC Taxonomy Code: 367500000X

State License MO 057425

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

17 Associated Practitioners
Cheryl Cerutti , CRNA

Registered Nurse

NPI 1255321402

Certified Registered Nurse Anesthetist

Judy Lohrer , CRNA

Nurse Anesthetist, Certified Registered

NPI 1285624346

Certified Registered Nurse Anesthetist

Andrea Newport , CRNA

Registered Nurse

NPI 1306827910

Certified Registered Nurse Anesthetist

NPI 1306837414

Doctor of Medicine (M.D.)

Dr. Soon Kim , MD

Anesthesiology

NPI 1396735551

Doctor of Medicine (M.D.)

Julie Stone , CRNA

Registered Nurse

NPI 1477544120

Certified Registered Nurse Anesthetist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 12303 DEPAUL DRIVE, BRIDGETON, MO 63044 (Tel: 3143447049)

📍
Updated Business Mailing Address July 08, 2007

Registered at 12303 DEPAUL DRIVE, BRIDGETON, MO 63044 (Tel: 3143447049)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as GARY CLARK, CRNA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Registered Nurse (License #RN057425 in MO)

🟢
Initial NPI Registration & Enumeration November 11, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1063493468
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 11, 2005
Last Update: July 13, 2026
Sole Proprietor: No

Mailing Address

12303 Depaul Drive

Bridgeton, MO 63044

Phone: 3143447049

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.