Active NPI
Dessie Clark, RPH
- Pharmacist
- Nashville, NC
National Provider Identifier
1003211053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6893
- Practice address
- 261 Private LN
Nashville, NC 27856-8114 - Phone
- (252) 937-2284
- NPI assigned
- Oct 31, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6893 | NC | Primary |
Addresses
Primary practice location
261 Private LN
Nashville, NC 27856-8114
Mailing address
261 Private LN
Nashville, NC 27856-8114
Phone (252) 937-2284
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11021979 | Other | NC | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6893 | NC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414713600000",
"number": "1003211053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "261 PRIVATE LN",
"city": "NASHVILLE",
"state": "NC",
"postal_code": "278568114",
"telephone_number": "252-937-2284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "261 PRIVATE LN",
"city": "NASHVILLE",
"state": "NC",
"postal_code": "278568114",
"telephone_number": "252-937-2284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "DESSIE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-31",
"last_updated": "2014-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "6893",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "11021979",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nashville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.