Active NPI
Clarence Alvin Roberts Jr., D.PH
- Pharmacist
- Tulsa, OK
National Provider Identifier
1467737411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 8288
- Practice address
- 1438 N Lewis Ave
Tulsa, OK 74110-0746 - Phone
- (918) 583-7593
- NPI assigned
- Oct 20, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 8288 | OK | Primary |
Addresses
Primary practice location
1438 N Lewis Ave
Tulsa, OK 74110-0746
Mailing address
1438 N Lewis Ave
Tulsa, OK 74110-0746
Phone (918) 583-7593
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 |
|---|---|---|---|
| 8288 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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": "1319068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319068800000",
"number": "1467737411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1438 N LEWIS AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741100746",
"telephone_number": "918-583-7593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1438 N LEWIS AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741100746",
"telephone_number": "918-583-7593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "CLARENCE",
"middle_name": "ALVIN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.PH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-20",
"last_updated": "2011-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "8288",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.