Active NPI
Christopher Edmund Clayton, PHARMD
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Waterloo, IA
National Provider Identifier
1447628615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 19396
- Practice address
- 1825 Logan Ave
Waterloo, IA 50703-1916 - Phone
- (319) 235-3660
- Fax
- (319) 235-3184
- NPI assigned
- Sep 4, 2015
- Last updated
- Sep 4, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 19396 | IA | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 19396 | IA | Primary |
Addresses
Primary practice location
1825 Logan Ave
Waterloo, IA 50703-1916
Mailing address
18889 161St Ave
Manchester, IA 52057-8898
Phone (319) 939-2569
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 |
|---|---|---|---|
| 19396 | IA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Organizations & group practices 3
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.
-
dba Prairie Parkway Pharmacy
- Clinic Pharmacy
- Cedar Falls, IA
- NPI 1598215659
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441324800000",
"number": "1447628615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18889 161ST AVE",
"city": "MANCHESTER",
"state": "IA",
"postal_code": "520578898",
"telephone_number": "319-939-2569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1825 LOGAN AVE",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507031916",
"telephone_number": "319-235-3660",
"fax_number": "319-235-3184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAYTON",
"first_name": "CHRISTOPHER",
"middle_name": "EDMUND",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-09-04",
"last_updated": "2015-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "19396",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "IA",
"license": "19396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.