Active NPI
Clarissa Miller, PHARMD
- Pharmacist
- Tsaile, AZ
National Provider Identifier
1346862026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S024290
- Practice address
- Tsaile Medical Center Indian Rte 64
Tsaile, AZ 86556 - Phone
- (928) 724-3600
- NPI assigned
- May 15, 2020
- Last updated
- May 15, 2020
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | S024290 | AZ | Primary |
Addresses
Primary practice location
Tsaile Medical Center Indian Rte 64
Tsaile, AZ 86556
Mailing address
PO Box C021
Tsaile, AZ 86556-5048
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S024290 | Other | AZ | ARIZONA STATE BOARD OF PHARMACY |
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 |
|---|---|---|---|
| S024290 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589500800000",
"number": "1346862026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX C021",
"city": "TSAILE",
"state": "AZ",
"postal_code": "865565048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "TSAILE MEDICAL CENTER INDIAN RTE 64",
"city": "TSAILE",
"state": "AZ",
"postal_code": "86556",
"telephone_number": "928-724-3600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "CLARISSA",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-15",
"last_updated": "2020-05-15",
"certification_date": "2020-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S024290",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARIZONA STATE BOARD OF PHARMACY",
"identifier": "S024290",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tsaile, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.