Individual provider Active NPI

Clea Antika Poole, RN

  • Registered Nurse
  • Richmond HTS, OH
National Provider Identifier
1992976336
Registry record updated Feb 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
347165 Issued in OH
Practice address
26710 Whiteway Dr
Apt. D129
Richmond HTS, OH 44143-1109
Phone
(216) 624-2177
NPI assigned
Mar 13, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 347165 OH Primary

Addresses

Primary practice location

26710 Whiteway Dr
Apt. D129
Richmond HTS, OH 44143-1109

Mailing address

26710 Whiteway Dr
Apt. D129
Richmond HTS, OH 44143-1109
Phone (216) 624-2177

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 Nurse

State licenses

LicenseStateTypeSpecialty
347165OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234310400000",
    "number": "1992976336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26710 WHITEWAY DR",
            "address_2": "APT. D129",
            "city": "RICHMOND HTS",
            "state": "OH",
            "postal_code": "441431109",
            "telephone_number": "216-624-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26710 WHITEWAY DR",
            "address_2": "APT. D129",
            "city": "RICHMOND HTS",
            "state": "OH",
            "postal_code": "441431109",
            "telephone_number": "216-624-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "CLEA",
        "middle_name": "ANTIKA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-13",
        "last_updated": "2009-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "347165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond HTS, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.