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Deactivated NPI 1922333970 Deactivated / Inactive NPI Male Practitioner

Justin A Clark , AA

Anesthesiologist Assistant • Cincinnati, OH

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Justin Clark has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 08, 2009
NPI Deactivation Date December 03, 2020
Total Practice Duration ~11 Years of Practice (2009 – 2020)

Professional Overview & Biography Verified Profile Summary

Justin Clark, AA was a registered Anesthesiologist Assistant practicing in Cincinnati, OH. Throughout an active medical career spanning 11 years, Justin Clark provided care at the practice location at 2139 AUBURN AVE until profile deactivation on 2020-12-03.

Practice Location & Contact Primary Location

Practice Address

2139 Auburn Ave

Cincinnati, OH 452192906

Telephone 5135852000
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Anesthesiologist Assistant in Cincinnati, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.1 Yrs
State Avg: 11.2 Yrs
Regional Practice Density
57 Specialists

Practicing in Cincinnati, OH (454 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Anesthesiologist Assistant Primary Specialty

NUCC Taxonomy Code: 367H00000X

State License OH 67.000156

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

Practice Associates & Co-Workers

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

40 Associated Practitioners
Christian Von Harten

Anesthesiologist Assistant

NPI 1003610320
Sarah Newman

Physician Assistant

NPI 1033000237
Joseph Aitken , CAA

Anesthesiologist Assistant

NPI 1033914080
Kathryn Breidenstein

Anesthesiologist Assistant

NPI 1033958301
Tashia Bailey , ARNP-BC, ACNP, MSN

Clinical Nurse Specialist - Acute Care

NPI 1043414162

ARNPBC, ACNP, Master of Science in Nursing

Julian Jones

Physician Assistant

NPI 1073381950

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated December 03, 2020

Record deactivated on December 03, 2020

NPI Profile Active October 08, 2009

NPI status registered as active in NPPES database

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Updated Practice Location October 08, 2009

Registered at 2139 AUBURN AVE, CINCINNATI, OH 452192906 (Tel: 5135852000)

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Updated Business Mailing Address October 08, 2009

Registered at 255 WEST MICHIGAN AVE,, JACKSON, MICHIGAN, MI 492041123 (Tel: 5177876440)

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Provider Name / Credentials Updated October 08, 2009

Recorded as JUSTIN CLARK, AA

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 08, 2009

Anesthesiologist Assistant (License #67.000156 in OH)

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Initial NPI Registration & Enumeration October 08, 2009

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: 1922333970
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 08, 2009
Last Update: October 08, 2009
Deactivation Date: December 03, 2020

Mailing Address

255 West Michigan Ave,, Jackson

Michigan, MI 492041123

Phone: 5177876440

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

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