Individual provider Active NPI

Clarissa Thurman O'Donnell, PT

  • Physical Therapist
  • Mechanicsburg, PA
National Provider Identifier
1003071291
Registry record updated Nov 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011676L Issued in PA
Practice address
5108 E Trindle Rd
Suite 200
Mechanicsburg, PA 17050-3300
Phone
(717) 790-9920
Fax
(717) 790-9923
NPI assigned
Jul 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT011676L PA Primary
Pediatric Physical Therapist 2251P0200X PT011676L PA

Addresses

Primary practice location

5108 E Trindle Rd
Suite 200
Mechanicsburg, PA 17050-3300

Mailing address

5300 Derry St
2ND Floor
Harrisburg, PA 17111-3576
Phone (717) 839-2110

Other names 1

  • Clarissa Thurman Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT011676LPAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448841600000",
    "number": "1003071291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 DERRY ST",
            "address_2": "2ND FLOOR",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113576",
            "telephone_number": "717-839-2110",
            "fax_number": "717-565-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5108 E TRINDLE RD",
            "address_2": "SUITE 200",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170503300",
            "telephone_number": "717-790-9920",
            "fax_number": "717-790-9923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "CLARISSA",
        "middle_name": "THURMAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2015-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT011676L",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "PA",
            "license": "PT011676L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLARISSA",
            "last_name": "THURMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mechanicsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; 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.