Active NPI
Kerry McCrae Clark, PHARMD
- Pharmacist
- Alfred, NY
National Provider Identifier
1306159983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 20054475
- Practice address
- 36 N Main St
Alfred, NY 14802-1011 - Phone
- (607) 587-9222
- Fax
- (607) 587-9629
- NPI assigned
- Jul 23, 2010
- 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 | 20054475 | NY | Primary |
Addresses
Primary practice location
36 N Main St
Alfred, NY 14802-1011
Mailing address
1917 Route 19
Wellsville, NY 14895-9740
Phone (585) 593-5754
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 |
|---|---|---|---|
| 20054475 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alfred Pharmacy Inc | Past | Accepting new patients | |
| Alfred Pharmacy Inc | 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
- Alfred, NY
- NPI 1285746297
-
- Long Term Care Pharmacy
- Alfred, NY
- NPI 1952953747
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279843200000",
"number": "1306159983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1917 ROUTE 19",
"city": "WELLSVILLE",
"state": "NY",
"postal_code": "148959740",
"telephone_number": "585-593-5754",
"fax_number": "585-593-5754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 N MAIN ST",
"city": "ALFRED",
"state": "NY",
"postal_code": "148021011",
"telephone_number": "607-587-9222",
"fax_number": "607-587-9629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "KERRY",
"middle_name": "MCCRAE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-23",
"last_updated": "2010-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "20054475",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alfred, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.