Active NPI
Clark Allen, PHARMD
- Pharmacist
- Memphis, TN
National Provider Identifier
1811468606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 39242
- Practice address
- 877 Jefferson Ave
Memphis, TN 38103-2807 - Phone
- (901) 545-6078
- Fax
- (901) 545-7557
- NPI assigned
- Dec 6, 2018
- Last updated
- Dec 6, 2018
- Sex
- Male
- 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 | 39242 | TN | Primary |
Addresses
Primary practice location
877 Jefferson Ave
Memphis, TN 38103-2807
Mailing address
877 Jefferson Ave
Memphis, TN 38103-2807
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39242 | Other | TN | TENNESSEE STATE LICENSE |
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 |
|---|---|---|---|
| 39242 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544054400000",
"number": "1811468606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "877 JEFFERSON AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381032807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "877 JEFFERSON AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381032807",
"telephone_number": "901-545-6078",
"fax_number": "901-545-7557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "CLARK",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-06",
"last_updated": "2018-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "39242",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TENNESSEE STATE LICENSE",
"identifier": "39242",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.