Active NPI
Robert James McClellan, PHARMD
- Pharmacist
- Salt Lake City, UT
National Provider Identifier
1134840473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9801291-1701
- Practice address
- 1220 E 3900 S Ste 1H
Salt Lake City, UT 84124-1327 - Phone
- (801) 477-8304
- Fax
- (801) 997-8404
- NPI assigned
- Sep 6, 2022
- Sex
- Male
- 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 | 9801291-8911 | UT | |
| Pharmacist | 183500000X | 9801291-1701 | UT | Primary |
Addresses
Primary practice location
1220 E 3900 S Ste 1H
Salt Lake City, UT 84124-1327
Mailing address
12063 S 540 E
Draper, UT 84020-9009
Phone (801) 349-0615
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 |
|---|---|---|---|
| 9801291-1701 | UT | MD | Pharmacist |
| 9801291-8911 | UT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662422400000",
"number": "1134840473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12063 S 540 E",
"city": "DRAPER",
"state": "UT",
"postal_code": "840209009",
"telephone_number": "801-349-0615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 E 3900 S STE 1H",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841241327",
"telephone_number": "801-477-8304",
"fax_number": "801-997-8404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLELLAN",
"first_name": "ROBERT",
"middle_name": "JAMES",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-06",
"last_updated": "2022-09-06",
"certification_date": "2022-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "9801291-8911",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "9801291-1701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.