Active NPI
Trenita Clark, PHARMD
- Pharmacist
- Raleigh, NC
National Provider Identifier
1639487614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18621
- Practice address
- 3500 Wake Forest Rd
Raleigh, NC 27609-7307 - Phone
- (919) 855-5694
- NPI assigned
- Sep 23, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18621 | NC | Primary |
| Pharmacist | 183500000X | 26022210A | IN |
Addresses
Primary practice location
3500 Wake Forest Rd
Raleigh, NC 27609-7307
Mailing address
3500 Wake Forest Rd
Raleigh, NC 27609-7307
Phone (919) 855-5694
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26022210A | IN | MD | Pharmacist |
| 18621 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310428800000",
"number": "1639487614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 WAKE FOREST RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276097307",
"telephone_number": "919-855-5694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 WAKE FOREST RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276097307",
"telephone_number": "919-855-5694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "TRENITA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-23",
"last_updated": "2011-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "18621",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26022210A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.