Active NPI
Clara Clark
- Speech-Language Pathologist
- Providence, RI
National Provider Identifier
1346584679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP00991
- Practice address
- 455 Douglas Ave
Providence, RI 02908-2542 - Phone
- (401) 553-8600
- NPI assigned
- Nov 27, 2012
- Last updated
- Nov 27, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP00991 | RI | Primary |
Addresses
Primary practice location
455 Douglas Ave
Providence, RI 02908-2542
Mailing address
115 Main Ave
Warwick, RI 02886-3631
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 |
|---|---|---|---|
| SP00991 | RI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353974400000",
"number": "1346584679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 MAIN AVE",
"city": "WARWICK",
"state": "RI",
"postal_code": "028863631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 DOUGLAS AVE",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029082542",
"telephone_number": "401-553-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "CLARA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-27",
"last_updated": "2012-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "RI",
"license": "SP00991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.