Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Cody Clark

Individual provider Certified Registered Nurse Anesthetist · NPI 1720442866

Cody Clark is a Certified Registered Nurse Anesthetist (CRNA) in Lebanon, Pennsylvania. Qualified in 2016, 10 years ago. Practices with Wellspan Medical Group, a 2,342-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
10
Licensed in
PA
In the registry since
2016
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Practice location Address checks out

252 S 4th St
Lebanon, PA 17042-6111
Phone: (717) 270-7500
Fax: (717) 228-1642
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 169 Martin Ave, Ephrata, PA 17522-1734 — (717) 733-0311
  • 55 Monument Rd, York, PA 17403-5023 — (717) 812-6425
  • 25 Monument Rd Ste 270, York, PA 17403-5073 — (717) 741-8250
  • 1001 S George St, York, PA 17403-3676 — (717) 812-7687

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence RN626823 (PA)

Record details

NPI number1720442866
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 5, 2016
Last updated in NPPESApril 2, 2026
Certification dateApril 2, 2026
Mailing address601 Memory Ln, York, PA 17402-2231

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Wellspan Medical Group — 2342 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Lebanon