Active NPI
Joe H Clark, PHARMACIST
- Pharmacist
- Pass Christian, MS
National Provider Identifier
1619269602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E05858
- Practice address
- 11470 Katie Dr
Pass Christian, MS 39571-5305 - Phone
- (228) 255-2886
- NPI assigned
- May 9, 2011
- Last updated
- May 9, 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 | E05858 | MS | Primary |
Addresses
Primary practice location
11470 Katie Dr
Pass Christian, MS 39571-5305
Mailing address
11470 Katie Dr
Pass Christian, MS 39571-5305
Phone (228) 255-2886
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 |
|---|---|---|---|
| E05858 | MS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304899200000",
"number": "1619269602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11470 KATIE DR",
"city": "PASS CHRISTIAN",
"state": "MS",
"postal_code": "395715305",
"telephone_number": "228-255-2886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11470 KATIE DR",
"city": "PASS CHRISTIAN",
"state": "MS",
"postal_code": "395715305",
"telephone_number": "228-255-2886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JOE",
"middle_name": "H",
"name_prefix": "Mr.",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-05-09",
"last_updated": "2011-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E05858",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pass Christian, MS
- Beach Therapy, LLC
- Beacon Therapy LLC
- James B Benigno Jr., O.D.
- Jeannette Bolte, PHD
- Calm Minds LLC
- Katrina Clark
- Coast Eyecare, PLLC
- Coastal Family Health Center, Inc (Coastal Family Health Center, Inc - Mobile Care)
- Coastal Family Health Center, Inc. (Pass Christian Health Center)
- Colorful Minds, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.