Active NPI
Michelle Renee Clements, RPH
- Pharmacist
- Kenosha, WI
National Provider Identifier
1669794889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12439
- Practice address
- 4100 52ND St
Kenosha, WI 53144-3900 - Phone
- (262) 658-0902
- Fax
- (262) 658-0560
- NPI assigned
- Feb 16, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12439 | WI | Primary |
Addresses
Primary practice location
4100 52ND St
Kenosha, WI 53144-3900
Mailing address
4100 52ND St
Kenosha, WI 53144-3900
Phone (262) 658-0902
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12439 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267056000000",
"number": "1669794889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 52ND ST",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531443900",
"telephone_number": "262-658-0902",
"fax_number": "262-658-0560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 52ND ST",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531443900",
"telephone_number": "262-658-0902",
"fax_number": "262-658-0560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMENTS",
"first_name": "MICHELLE",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-16",
"last_updated": "2010-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "12439",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.