Individual provider Active NPI

Lauren Clevinger, PHARMD

  • Pharmacist
  • Johnson City, TN
National Provider Identifier
1376845925
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202208726 Issued in VA
Practice address
4307 N Roan St
Johnson City, TN 37615-5036
Phone
(423) 952-0088
NPI assigned
Dec 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 35525 TN
Pharmacist 183500000X 0202208726 VA Primary

Addresses

Primary practice location

4307 N Roan St
Johnson City, TN 37615-5036

Mailing address

4307 N Roan St
Johnson City, TN 37615-5036
Phone (423) 952-0088

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

LicenseStateTypeSpecialty
35525TNMDPharmacist
0202208726VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Limited Partnership I Past Accepting new patients
Kroger Limited Partnership I 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.

NPI Registry JSON

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1376845925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4307 N ROAN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376155036",
            "telephone_number": "423-952-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4307 N ROAN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376155036",
            "telephone_number": "423-952-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVINGER",
        "first_name": "LAUREN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-01",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "35525",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202208726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.

Verify at the official NPI Registry.