Cody Clark
NPI 1720442866ActiveIndividual· Nurse Anesthetist, Certified Registered· Lebanon, PA
Nurse Anesthetist, Certified Registered with Wellspan Medical Group, practicing in Lebanon, Pennsylvania. Medicare paid $9,912 for services to 131 patients in 2024. Medtronic, Inc. reported $16.60 in payments in 2025, mostly food and beverage. Lists Wellspan Good Samaritan Hospital as a hospital affiliation.
Overview
| NPI | 1720442866 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Apr 5, 2016 |
| Last updated in NPPES | Apr 2, 2026 |
| Certified by provider | Apr 2, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Anesthetist, Certified Registered Primary | 367500000X | RN626823 | PA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Certified Registered Nurse Anesthetist (CRNA) (PA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 131 |
|---|---|
| Services billed | 132 across 24 procedure codes |
| Paid by Medicare | $9,912 |
Education and affiliations
| Graduation year | 2016 |
|---|---|
| Medicare specialty | Certified Registered Nurse Anesthetist (Crna) |
Medical group
- Wellspan Medical GroupEphrata, PA · 2,480 clinicians
Hospital affiliation
- Wellspan Good Samaritan HospitalLebanon, PA
Industry payments (Open Payments)
- 2025$16.60 · 1 payment from 1 company
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Medtronic, Inc. | $16.60 | 1 |
What the 2025 payments were for
- Food and Beverage$16.60 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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