MEDICARE: JAMES MICHAEL CLARK CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN.1672019	CO
2	367500000X	Certified Registered Nurse Anesthetist	APN.0996173-CRNA	CO

General Provider Information

NPI Number	:	1518167600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES MICHAEL CLARK CRNA

Provider Business Mailing Address
First Line	:	5538 GOLDEN WILLOW DR
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-6395
Country	:	US
Telephone Number	:	404-840-3413
Fax Number	:

Provider Business Practice Location Address
First Line	:	5538 GOLDEN WILLOW DR
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-6395
Country	:	US
Telephone Number	:	404-840-3413
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2007
Last Update Date	:	04/08/2026

Similar Medicare Providers

1033350772 — MYA JANELL MONTOYA CRNA
Practice Location Address:

5538 GOLDEN WILLOW DR
FORT COLLINS, CO
80528-6395

Practice Phone: 404-825-3073
Practice Fax: 888-512-2215

1942733589 — KELLY HALE APRN
Practice Location Address:

9557 N BEACH ST
FORT WORTH, TX
76244-6395

Practice Phone: 817-741-5050
Practice Fax:

1821594219 — ELIJAH AUSTIN LACKEY MD
Practice Location Address:

2121 E HARMONY RD
FORT COLLINS, CO
80528-3400

Practice Phone: 970-226-6111
Practice Fax: 970-226-6707

1972556991 — ADVANCED NEUROLOGY OF COLORADO, LLC
Practice Location Address:

2121 E HARMONY RD , SUITE 180
FORT COLLINS, CO
80528-3400

Practice Phone: 970-226-6111
Practice Fax: 970-226-6707

1437661170 — COURTNEY WEIR NP
Practice Location Address:

2121 E HARMONY RD UNIT 180
FORT COLLINS, CO
80528-3401

Practice Phone: 970-226-6111
Practice Fax:

1942269873 — MR. DONALD R KELLY P.A.
Practice Location Address:

2121 E HARMONY RD , STE 330
FORT COLLINS, CO
80528-3400

Practice Phone: 970-221-5878
Practice Fax: 970-221-3564

Directions to “ JAMES MICHAEL CLARK CRNA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.