Active NPI
Summer Clark, PHARMD
- Pharmacist
- Charlotte, NC
National Provider Identifier
1063760874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 22619
- Practice address
- 5810 Highland Shoppes Dr.
Charlotte, NC 28269-1138 - Phone
- (704) 875-7128
- Fax
- (704) 875-7378
- NPI assigned
- Aug 28, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13722 | SC | |
| Pharmacist | 183500000X | 22619 | NC | Primary |
Addresses
Primary practice location
5810 Highland Shoppes Dr.
Charlotte, NC 28269-1138
Mailing address
701 Crestdale Rd.
Matthews, NC 28105
Phone (919) 757-5405
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22619 | NC | MD | Pharmacist |
| 13722 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harris Teeter, LLC | Past | Accepting new patients | |
| Harris Teeter LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Apex, NC
- NPI 1225856859
-
- Community/Retail Pharmacy
- Charlotte, NC
- NPI 1699877092
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442275200000",
"number": "1063760874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 CRESTDALE RD.",
"city": "MATTHEWS",
"state": "NC",
"postal_code": "28105",
"telephone_number": "919-757-5405",
"fax_number": "843-216-7028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5810 HIGHLAND SHOPPES DR.",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282691138",
"telephone_number": "704-875-7128",
"fax_number": "704-875-7378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "SUMMER",
"name_prefix": "Mrs.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-28",
"last_updated": "2015-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "13722",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "22619",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.