Active NPI
Abigail Louise Clark
- Pharmacist
- Ashtabula, OH
National Provider Identifier
1427659705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03338060
- Practice address
- 3551 N Ridge East
Ashtabula, OH 44004-4313 - Phone
- (440) 998-4004
- NPI assigned
- Nov 4, 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 | 03338060 | OH | Primary |
Addresses
Primary practice location
3551 N Ridge East
Ashtabula, OH 44004-4313
Mailing address
125 Longview Cir
North Lima, OH 44452-9551
Phone (330) 402-9759
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 |
|---|---|---|---|
| 03338060 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604448000000",
"number": "1427659705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 LONGVIEW CIR",
"city": "NORTH LIMA",
"state": "OH",
"postal_code": "444529551",
"telephone_number": "330-402-9759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 N RIDGE EAST",
"city": "ASHTABULA",
"state": "OH",
"postal_code": "440044313",
"telephone_number": "440-998-4004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "ABIGAIL",
"middle_name": "LOUISE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-04",
"last_updated": "2020-11-04",
"certification_date": "2020-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03338060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ashtabula, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.