Individual provider Active NPI

Martha I Clonch

  • Licensed Practical Nurse
  • Springfield, OH
National Provider Identifier
1013687003
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
096733 Issued in OH
Practice address
2317 E Home Rd
Springfield, OH 45503-2520
Phone
(937) 390-8060
NPI assigned
Sep 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164W00000X 096733 OH Primary

Addresses

Primary practice location

2317 E Home Rd
Springfield, OH 45503-2520

Mailing address

2317 E Home Rd
Springfield, OH 45503-2520
Phone (937) 390-8060

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

State licenses

LicenseStateTypeSpecialty
096733OHMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1013687003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 E HOME RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032520",
            "telephone_number": "937-390-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 E HOME RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032520",
            "telephone_number": "937-390-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLONCH",
        "first_name": "MARTHA",
        "middle_name": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-20",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "096733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.