Richard Joseph McClimon, RPH

Key facts

NPI

1043375413

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist 183500000X

License

051-060163 (IL)

Practice address

114 S State St
Geneseo, IL 61254-1348

Phone

(309) 944-2166

Fax

(309) 944-3574

NPI assigned

Dec 26, 2006

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Pharmacist

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 11, 2013.

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357862400000",
    "number": "1043375413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 S STATE ST",
            "city": "GENESEO",
            "state": "IL",
            "postal_code": "612541348",
            "telephone_number": "309-944-2166",
            "fax_number": "309-944-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 S STATE ST",
            "city": "GENESEO",
            "state": "IL",
            "postal_code": "612541348",
            "telephone_number": "309-944-2166",
            "fax_number": "309-944-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLIMON",
        "first_name": "RICHARD",
        "middle_name": "JOSEPH",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2013-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-060163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363540285001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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