Active NPI
Jeanne Clyde Clinard
- Pharmacist
- Wilmington, NC
National Provider Identifier
1699056804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9664
- Practice address
- 4600 Oleander Dr
Wilmington, NC 28403-5149 - Phone
- (910) 392-1921
- Fax
- (910) 791-3435
- NPI assigned
- Sep 1, 2011
- 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 | 9664 | NC | Primary |
Addresses
Primary practice location
4600 Oleander Dr
Wilmington, NC 28403-5149
Mailing address
4600 Oleander Dr
Wilmington, NC 28403-5149
Phone (910) 392-1921
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0655464 | Medicaid | NC |
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 |
|---|---|---|---|
| 9664 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314835200000",
"number": "1699056804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4600 OLEANDER DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284035149",
"telephone_number": "910-392-1921",
"fax_number": "910-791-3435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 OLEANDER DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284035149",
"telephone_number": "910-392-1921",
"fax_number": "910-791-3435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLINARD",
"first_name": "JEANNE",
"middle_name": "CLYDE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-01",
"last_updated": "2011-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "9664",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0655464",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.