Jennifer Lynne Clark, PHARMD, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

03-1-20803 Issued in OH

Practice address

1001 Bellefontaine Ave
Lima, OH 45804-2800

Phone

(419) 221-6142

NPI assigned

Nov 7, 2005

Last updated

Sep 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy, Registered Pharmacist

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1093796245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 N DIXIE HWY",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458012235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BELLEFONTAINE AVE",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458042800",
            "telephone_number": "419-221-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JENNIFER",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03-1-20803",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OH",
            "license": "03-1-20803",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Gail Cisco, CDCA
• Stacy M Cisco, OTR/L
• City of Lima (Lima Fire Department)
• Danielle Clabaugh, RN
• Christopher Lee Clancy, M.D.
• Jerri Clark, BSW
• Josie Clark, CDCA
• Monica Annette Clark
• Sara Brittany Elyse Clark
• Clark's RX LLC (Clark's RX)

• Pharmacist in Lima, OH
• Providers in Lima, OH by specialty
• Pharmacist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.