Individual provider Active NPI

Spencer E Clairmont, R.PH. ,FELLOW, ASCP

  • Pharmacist
  • Walhalla, ND
National Provider Identifier
1871696385
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
3440 Issued in ND
Practice address
1102 Central Avenue
Walhalla, ND 58282-0428
Phone
(701) 549-2661
Fax
(701) 549-2664
NPI assigned
Sep 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 3440 ND Primary

Addresses

Primary practice location

1102 Central Avenue
Walhalla, ND 58282-0428

Mailing address

1102 Central Avenue
PO Box 428
Walhalla, ND 58282-0428
Phone (701) 549-2661

Other identifiers 1

IdentifierTypeStateIssuer
3440OtherNDPHARMACIST LISCENCE NUMBE

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
3440NDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Nudak Ventures North Dakota, LLC PastSince Dec 12, 2021 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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871696385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 CENTRAL AVENUE",
            "address_2": "PO BOX 428",
            "city": "WALHALLA",
            "state": "ND",
            "postal_code": "582820428",
            "telephone_number": "701-549-2661",
            "fax_number": "701-549-2664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 CENTRAL AVENUE",
            "city": "WALHALLA",
            "state": "ND",
            "postal_code": "582820428",
            "telephone_number": "701-549-2661",
            "fax_number": "701-549-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAIRMONT",
        "first_name": "SPENCER",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "R.PH. ,FELLOW, ASCP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "3440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LISCENCE NUMBE",
            "identifier": "3440",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walhalla, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.