Active NPI
Ruth Clark
- Pharmacist
- Mount Vernon, IA
National Provider Identifier
1114987575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17905
- Practice address
- 113 1St St E
Mount Vernon, IA 52314-1422 - Phone
- (319) 895-6248
- Fax
- (319) 895-6991
- NPI assigned
- Mar 27, 2006
- Last updated
- Jul 13, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17905 | IA | Primary |
Addresses
Primary practice location
113 1St St E
Mount Vernon, IA 52314-1422
Mailing address
724 4TH Ave N
Mount Vernon, IA 52314-1105
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17905 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1114987575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "724 4TH AVE N",
"city": "MOUNT VERNON",
"state": "IA",
"postal_code": "523141105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 1ST ST E",
"city": "MOUNT VERNON",
"state": "IA",
"postal_code": "523141422",
"telephone_number": "319-895-6248",
"fax_number": "319-895-6991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "RUTH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-27",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "17905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, IA
- Emily Appleton, PAC
- Aurora Aesthetics and Functional Medicine Clinic, PLLC (Aurora Functional Medicine & Aesthetics Clinic)
- Thomas M. Barnes, D.D.S.
- Ann Michelle Brase, PT
- Erica Ann Buffington, LMSW
- Adam Clendenen, PT, DPT
- Cornelius Chiropractic Centre, LTD.
- CR Pharmacy Service, Inc (CarePro Pharmacy - Mt Vernon)
- Madigan Jane Crowley, TLMHC
- Benjamin Harrison Daniels, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.