Active NPI
Kenneth Clark
- Registered Nurse
- Pottstown, PA
National Provider Identifier
1669878443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN664213
- Practice address
- 724 N Charlotte St
Pottstown, PA 19464-4607 - Phone
- (610) 323-1837
- NPI assigned
- Nov 6, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN664213 | PA | Primary |
Addresses
Primary practice location
724 N Charlotte St
Pottstown, PA 19464-4607
Mailing address
300 Masters Drive
Pottstown, PA 19464
Phone (484) 250-3932
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 |
|---|---|---|---|
| RN664213 | PA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415232000000",
"number": "1669878443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 MASTERS DRIVE",
"city": "POTTSTOWN",
"state": "PA",
"postal_code": "19464",
"telephone_number": "484-250-3932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "724 N CHARLOTTE ST",
"city": "POTTSTOWN",
"state": "PA",
"postal_code": "194644607",
"telephone_number": "610-323-1837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "KENNETH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-06",
"last_updated": "2014-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "PA",
"license": "RN664213",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pottstown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.