William R Clark I, RN

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

RN521227 Issued in OH

Practice address

17273 State Route 104
Chillicothe, OH 45601-9718

Phone

(740) 773-1141

NPI assigned

Sep 14, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1710210489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17273 STATE ROUTE 207",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "45601",
            "telephone_number": "937-305-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17273 STATE ROUTE 104",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456019718",
            "telephone_number": "740-773-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-14",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OK",
            "license": "112658",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OH",
            "license": "RN521227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justice Kathlene Clark
• Maci Sue Clark
• Michele Lee Clark
• Queshon Clark, RN
• Rebecca Dawn Clark, RN
• Andrea Clary
• Christy Lynn Clary, LPN
• Doris A Clary, CDCA
• Jennifer Lynn Claytor
• Joshua Claytor

• General Practice Registered Nurse in Chillicothe, OH
• Providers in Chillicothe, OH by specialty
• General Practice Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.