Active NPI
Ian Clarke, PHARM.D.
- Pharmacist
- Port Saint Lucie, FL
National Provider Identifier
1164026894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS61498
- Practice address
- 9000 S US Highway 1
Port Saint Lucie, FL 34952-3408 - Phone
- (772) 337-0112
- NPI assigned
- Nov 23, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS61498 | FL | Primary |
Addresses
Primary practice location
9000 S US Highway 1
Port Saint Lucie, FL 34952-3408
Mailing address
9000 S US Highway 1
Port Saint Lucie, FL 34952-3408
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 |
|---|---|---|---|
| PS61498 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
9000 S US Highway 1
Port St Lucie, FL 34952
Phone (772) 337-0112
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.
-
- Pharmacy
- Port St Lucie, FL
- NPI 1245247238
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- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606089600000",
"number": "1164026894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9000 S US HIGHWAY 1",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349523408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9000 S US HIGHWAY 1",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349523408",
"telephone_number": "772-337-0112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARKE",
"first_name": "IAN",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-23",
"last_updated": "2020-11-23",
"certification_date": "2020-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS61498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.