Katherine T Clark, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

26027104A Issued in IN

Practice address

60101 Bodnar Blvd Ste 100
Mishawaka, IN 46544-9328

Phone

(574) 335-8500

NPI assigned

Apr 19, 2019

Last updated

May 21, 2021By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: katherine.clark@directsjrmc.mhin.net

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.

• Saint Joseph Regional Medical Center, Inc.

  dba Saint Joseph Medical Group

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1467406074
  NPD (past)

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1770146243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD STE 406",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451468",
            "telephone_number": "574-335-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60101 BODNAR BLVD STE 100",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465449328",
            "telephone_number": "574-335-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATHERINE",
        "middle_name": "T",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-19",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26027104A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Katherine.Clark@directsjrmc.mhin.net",
            "affiliation": "N",
            "endpointDescription": "Saint Joseph Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "60101 Bodnar Blvd Ste 100",
            "city": "Mishawaka",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465449328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aerie Chung, MD
• Barbara Chupp-Grove
• City of Mishawaka
• Kailee Claire, DPT
• Bernice Monique Clark, APRN
• Angel May Clements
• Grant Patrick Cleveland, DDS
• Stacey J Closson, LMHC
• Kimberly Anne Cloud, COTA
• Connie Clougher, RN

• Pharmacist in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Pharmacist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.