Active NPI
Purpose Physical Therapy and Wellness, LLC
- Orthopedic Physical Therapist
- St Petersburg, FL
National Provider Identifier
1003422064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- Legal business name
- PURPOSE PHYSICAL THERAPY AND WELLNESS, LLC
- Practice address
- 1212 66TH St N Ste 1214
St Petersburg, FL 33710-6226 - Phone
- (417) 315-5577
- Fax
- (727) 290-4917
- NPI assigned
- Sep 16, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kenneth John Clark Jr., DPT
- Title
- Owner/Ceo
- Phone
- (417) 315-5577
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | Primary |
Addresses
Primary practice location
1212 66TH St N Ste 1214
St Petersburg, FL 33710-6226
Mailing address
1212 66TH St N Ste 1214
St Petersburg, FL 33710-6226
Phone (417) 315-5577
Other names 1
- Purpose Physical Therapy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
724 Pasadena Ave S
South Pasadena, FL 33707
Phone (417) 315-5577
1212 66th St N
Ste 1214
St Petersburg, FL 33710
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Therapist
- Saint Petersburg, FL
- NPI 1144740580
-
- Physical Therapist
- South Pasadena, FL
- NPI 1356952667
-
- Physical Therapist
- South Pasadena, FL
- NPI 1639095375
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600214400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1785974400000",
"number": "1003422064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1212 66TH ST N STE 1214",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337106226",
"telephone_number": "417-315-5577",
"fax_number": "727-290-4917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 66TH ST N STE 1214",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337106226",
"telephone_number": "417-315-5577",
"fax_number": "727-290-4917"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PURPOSE PHYSICAL THERAPY AND WELLNESS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-09-16",
"last_updated": "2026-08-06",
"certification_date": "2026-08-06",
"status": "A",
"authorized_official_last_name": "CLARK",
"authorized_official_first_name": "KENNETH",
"authorized_official_middle_name": "JOHN",
"authorized_official_title_or_position": "OWNER/CEO",
"authorized_official_telephone_number": "417-315-5577",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "DPT"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist, Orthopedic",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Purpose Physical Therapy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Purpose Physical Therapy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.