Pamela Clark

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

3110958 Issued in OH

Practice address

2519 N Holland Sylvania Rd
Toledo, OH 43615-2720

Phone

(419) 843-4299

NPI assigned

Jul 17, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1679126791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 THATCHER DR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436064258",
            "telephone_number": "419-509-1937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2519 N HOLLAND SYLVANIA RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436152720",
            "telephone_number": "419-843-4299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "PAMELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": "3110958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3110958",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PWCLARK@BEX.NET",
            "affiliation": "N",
            "address_1": "2519 N Holland Sylvania Rd",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436152720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karli T Clark, MSN, APRN, PMHNP-BC
• La Keisha Ly-Nea Clark, MA
• Marcia Clark, LSW
• Melissa Clark
• Nyssa Clark
• Paul M Clark, M.D.
• Priti Rose Clark
• Rachelle Nichole Clark, LPN
• Rondell Keair Clark
• Selina Clark

• Home Health Agency in Toledo, OH
• Providers in Toledo, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.