Active NPI
Amanda Jane Helton-Clark, PHARMD
- Pharmacist
- Jackson, TN
National Provider Identifier
1801486436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11805
- Practice address
- 1405 N Highland Ave
Jackson, TN 38301-3403 - Phone
- (731) 660-2845
- NPI assigned
- Jan 18, 2021
- Last updated
- Jan 19, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11805 | TN | Primary |
Addresses
Primary practice location
1405 N Highland Ave
Jackson, TN 38301-3403
Mailing address
3222 Central Ave
Memphis, TN 38111-3319
Other practice location 1
3222 Central Ave
Memphis, TN 38111-3319
Phone (901) 833-6108
Other names 1
- Amanda Jane Clark
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11805 | TN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tennessee CVS Pharmacy, L.L.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611014400000",
"number": "1801486436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3222 CENTRAL AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381113319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1405 N HIGHLAND AVE",
"city": "JACKSON",
"state": "TN",
"postal_code": "383013403",
"telephone_number": "731-660-2845"
}
],
"practiceLocations": [
{
"address_1": "3222 Central Ave",
"address_purpose": "LOCATION",
"city": "Memphis",
"state": "TN",
"postal_code": "381113319",
"country_code": "US",
"telephone_number": "901-833-6108",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HELTON-CLARK",
"first_name": "AMANDA",
"middle_name": "JANE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-18",
"last_updated": "2021-01-19",
"certification_date": "2021-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "11805",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "CLARK",
"middle_name": "JANE",
"credential": "PHARMD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Jackson, TN
- Amy C Heffernan, PTA
- Marvyn L Hegmon, LCSW
- David Scott Helm, M.D.
- Helping Hands of Middle & West Tennessee (Helping Hands of Tennessee)
- Helping Hands of Middle & West Tennessee (Helping Hands of Tennessee)
- Hematology Oncology Associates, PC
- Jennifer Hartwell Henderson, M.A. CCC-SLP
- Robert Owen Henderson Jr., DRPH
- Denean Hendren, APN
- Kenzie Britt Hendrix, DO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.