Individual provider Active NPI

Sherrie Marie Clark, MEDICAL ASSISTANT

  • Community Health Worker
  • Kansas City, KS
National Provider Identifier
1861621690
Registry record updated Jul 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
1223 N 50TH St
Kansas City, KS 66102-1605
Phone
(816) 332-7675
NPI assigned
Jul 14, 2009
Last updated
Jul 14, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X NU Primary

Addresses

Primary practice location

1223 N 50TH St
Kansas City, KS 66102-1605

Mailing address

1223 N 50TH St
Kansas City, KS 66102-1605
Phone (816) 332-7675

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

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247529600000",
    "number": "1861621690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 N 50TH ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661021605",
            "telephone_number": "816-332-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 N 50TH ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661021605",
            "telephone_number": "816-332-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SHERRIE",
        "middle_name": "MARIE",
        "credential": "MEDICAL ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2009-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; 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.