Individual provider Active NPI

Clarence A Pinkston

  • Registered Nurse First Assistant
  • Norcross, GA
National Provider Identifier
1396094264
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
RN147191 Issued in GA
Practice address
7742 Spalding Dr
115
Norcross, GA 30092-4207
Phone
(678) 580-2587
NPI assigned
Sep 6, 2012
Last updated
Sep 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X RN147191 GA Primary

Addresses

Primary practice location

7742 Spalding Dr
115
Norcross, GA 30092-4207

Mailing address

7742 Spalding Dr
115
Norcross, GA 30092-4207
Phone (678) 580-2587

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

LicenseStateTypeSpecialty
RN147191GAMDRegistered Nurse First Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1396094264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7742 SPALDING DR",
            "address_2": "115",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300924207",
            "telephone_number": "678-580-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7742 SPALDING DR",
            "address_2": "115",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300924207",
            "telephone_number": "678-580-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINKSTON",
        "first_name": "CLARENCE",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-06",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "GA",
            "license": "RN147191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.

Verify at the official NPI Registry.