Active NPI
Lily N Clarkson, FNP
- Nurse Practitioner
- San Andreas, CA
National Provider Identifier
1487091450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- NP7118
- Practice address
- 1113 Hwy 49
San Andreas, CA 95249 - Phone
- (209) 755-1400
- Fax
- (209) 755-1430
- NPI assigned
- May 30, 2013
- Last updated
- Jul 26, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NP7118 | CA | Primary |
Addresses
Primary practice location
1113 Hwy 49
San Andreas, CA 95249
Mailing address
PO Box 939
Angels Camp, CA 95222-0939
Phone (209) 754-6240
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 |
|---|---|---|---|
| NP7118 | CA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374796800000",
"number": "1487091450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 939",
"city": "ANGELS CAMP",
"state": "CA",
"postal_code": "952220939",
"telephone_number": "209-754-6240",
"fax_number": "209-754-6274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1113 HWY 49",
"city": "SAN ANDREAS",
"state": "CA",
"postal_code": "95249",
"telephone_number": "209-755-1400",
"fax_number": "209-755-1430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARKSON",
"first_name": "LILY",
"middle_name": "N",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-30",
"last_updated": "2013-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "NP7118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Andreas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.