Joshua Clark, NSCA-CPT

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

S62236208 Issued in MA

Practice address

170 School St
Watertown, MA 02472-4149

Phone

(774) 279-1044

NPI assigned

Dec 11, 2016

Last updated

Dec 11, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1481414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481414400000",
    "number": "1013451095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 SCHOOL ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724149",
            "telephone_number": "774-279-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 SCHOOL ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724149",
            "telephone_number": "774-279-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JOSHUA",
        "credential": "NSCA-CPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-11",
        "last_updated": "2016-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "S62236208",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "S62236208",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori S Cignarella, LICSW
• Rachel Ciniewicz
• Matthew Cipollone
• City of Watertown
• John Joseph Ciulla
• Lindsey Clark
• Melissa Ann Clay
• Erin Cohen
• Lisa Janice Cohen, MS, PT
• Andrea Cole

• Student in an Organized Health Care Education/Training Program in Watertown, MA
• Providers in Watertown, MA by specialty
• Student in an Organized Health Care Education/Training Program in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2016; 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.