Active NPI
James Clark
- Pharmacist
- Omaha, NE
National Provider Identifier
1457625782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15727
- Practice address
- 16130 Parker St
Omaha, NE 68118 - Phone
- (308) 830-0941
- NPI assigned
- Mar 5, 2012
- Sex
- Male
- Sole proprietor
- No
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 | 23219 | IA | |
| Pharmacist | 183500000X | 15727 | NE | Primary |
Addresses
Primary practice location
16130 Parker St
Omaha, NE 68118
Mailing address
16130 Parker St
Omaha, NE 68118-2429
Phone (308) 830-0941
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 |
|---|---|---|---|
| 23219 | IA | MD | Pharmacist |
| 15727 | NE | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526428800000",
"number": "1457625782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16130 PARKER ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681182429",
"telephone_number": "308-830-0941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16130 PARKER ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "68118",
"telephone_number": "308-830-0941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JAMES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-03-05",
"last_updated": "2018-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "23219",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "15727",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.