Margie Ann Clark, L.P.N.

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN.060868 Issued in OH

Practice address

3805 Fiesta Way
Middletown, OH 45044-6113

Phone

(513) 594-6477

NPI assigned

Apr 3, 2007

Last updated

Mar 18, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1376664649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 FIESTA WAY",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450446113",
            "telephone_number": "513-594-6477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 FIESTA WAY",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450446113",
            "telephone_number": "513-594-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MARGIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "L.P.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.060868",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN 5164948",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0940895634-03",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melanie A Clapp, LPN
• Clark Audiology LLC (Audiology Services)
• Clark RX LLC (Clark's RX Pharmacy)
• Ashley Clark, PHARMD
• John Greer Clark, PH.D.
• Suzanne Clark, AU.D.
• Jami Clarke
• Carol A Clemow
• Close to Home II, LLC
• Gary Arthur Cobb, M.D.

• Licensed Practical Nurse in Middletown, OH
• Providers in Middletown, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.