Active NPI
Sally E. Clark, LAC, RN
- Acupuncturist
- Annapolis, MD
National Provider Identifier
1700425311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- U02395
- Practice address
- 71 Old Mill Bottom Rd N Ste 102
Annapolis, MD 21409-5446 - Phone
- (443) 994-0087
- NPI assigned
- Dec 30, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | U02395 | MD | Primary |
Addresses
Primary practice location
71 Old Mill Bottom Rd N Ste 102
Annapolis, MD 21409-5446
Mailing address
3110 Landfall LN
Annapolis, MD 21403-4312
Phone (443) 994-0087
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 Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| U02395 | MD | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577664000000",
"number": "1700425311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3110 LANDFALL LN",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214034312",
"telephone_number": "443-994-0087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71 OLD MILL BOTTOM RD N STE 102",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214095446",
"telephone_number": "443-994-0087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "SALLY",
"middle_name": "E.",
"credential": "LAC, RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-30",
"last_updated": "2019-12-30",
"certification_date": "2019-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MD",
"license": "U02395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Annapolis, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.