Ann Elizabeth Clark-Delogu

Primary specialty

NaturopathTaxonomy code 175F00000X

License

4330 Issued in OR

Practice address

608 Lancaster Dr SE
Salem, OR 97317-5643

Phone

(503) 877-1995

NPI assigned

Sep 25, 2020

Last updated

Sep 25, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ann.clarkdelogu.p100@direct.wvp.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• JD Health and Wellness Center, Inc

  • Naturopath
  • Salem, OR
  • NPI 1689918161
  NPD (past)

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1700493608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11720 SE ALDER ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163868",
            "telephone_number": "206-902-7168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 LANCASTER DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973175643",
            "telephone_number": "503-877-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK-DELOGU",
        "first_name": "ANN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-25",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "4330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Salem (Salem Area Medical Transport)
• Tabitha Ciulla
• Andrea Clancy, DPT
• Patrick Clancy, CRM
• Katie Clanton, RDH, EPDH
• Alisha Sue Clark
• Danica E Clark, MD
• Ellis Richard Clark, MD
• Jev Clark
• Jim R Clark

• Naturopath in Salem, OR
• Providers in Salem, OR by specialty
• Naturopath in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.