Individual provider Active NPI

Rachael D. Clements-Maiden, R.PH.

  • Pharmacist
  • Monticello, IN
National Provider Identifier
1801419882
Registry record updated May 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26018927A Issued in IN
Practice address
1088 W Broadway St
Monticello, IN 47960-1816
Phone
(574) 583-3250
Fax
(574) 583-5438
NPI assigned
May 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26018927A IN Primary

Addresses

Primary practice location

1088 W Broadway St
Monticello, IN 47960-1816

Mailing address

12778 N 1225 W
Monticello, IN 47960-4740
Phone (574) 581-1972

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL rdcleme.s02771.us@wal-mart.com Direct

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 Pharmacist

State licenses

LicenseStateTypeSpecialty
26018927AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1590364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590364800000",
    "number": "1801419882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12778 N 1225 W",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479604740",
            "telephone_number": "574-581-1972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088 W BROADWAY ST",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479601816",
            "telephone_number": "574-583-3250",
            "fax_number": "574-583-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTS-MAIDEN",
        "first_name": "RACHAEL",
        "middle_name": "D.",
        "name_prefix": "Ms.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-25",
        "last_updated": "2020-05-25",
        "certification_date": "2020-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26018927A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "rdcleme.s02771.us@wal-mart.com",
            "affiliation": "N",
            "endpointDescription": "Walmart email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1088 W Broadway St",
            "city": "Monticello",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479601816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monticello, IN

Sources for this page

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