Individual provider Active NPI

Demetria Clardy, LPN

  • Licensed Practical Nurse
  • Columbus, OH
National Provider Identifier
1760907935
Registry record updated Aug 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
155966 Issued in OH
Practice address
4080 Karl Rd Apt B2
Columbus, OH 43224-2138
Phone
(614) 705-8072
NPI assigned
Aug 9, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 155966 OH Primary

Addresses

Primary practice location

4080 Karl Rd Apt B2
Columbus, OH 43224-2138

Mailing address

4080 Karl Rd Apt B2
Columbus, OH 43224-2138

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

LicenseStateTypeSpecialty
155966OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502236800000",
    "number": "1760907935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 KARL RD APT B2",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432242138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 KARL RD APT B2",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432242138",
            "telephone_number": "614-705-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARDY",
        "first_name": "DEMETRIA",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-09",
        "last_updated": "2017-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "155966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2017; 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.