Individual provider Active NPI

Craig Leo Clark, RPH

  • Pharmacist
  • Cedar Rapids, IA
National Provider Identifier
1487609111
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15253 Issued in IA
Practice address
1946 42ND St NE
Cedar Rapids, IA 52402
Phone
(319) 393-3210
Fax
(319) 393-2747
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15253 IA Primary

Addresses

Primary practice location

1946 42ND St NE
Cedar Rapids, IA 52402

Mailing address

1946 42ND St NE
Cedar Rapids, IA 52402
Phone (319) 393-3210

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
15253IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Clark'S Pharmacy, Inc Current Accepting new patients
Clark'S Pharmacy, Inc Current Accepting new patients
Clarks Medical Services LLC Current Accepting new patients

Locations

1946 42nd St NE
Cedar Rapids, IA 52402
Phone (319) 200-4266

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1487609111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1946 42ND ST NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52402",
            "telephone_number": "319-393-3210",
            "fax_number": "319-393-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1946 42ND ST NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52402",
            "telephone_number": "319-393-3210",
            "fax_number": "319-393-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CRAIG",
        "middle_name": "LEO",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "15253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.