Individual provider Active NPI

Brianna Clark, PT

  • Physical Therapist
  • West Lafayette, IN
National Provider Identifier
1043198344
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP053478T Issued in SC
Practice address
2548 Cumberland Ave Ste 100
West Lafayette, IN 47906-4083
Phone
(317) 802-2000
Fax
(317) 802-2050
NPI assigned
Aug 25, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CP048794T TN
Physical Therapist 225100000X 05016133A IN
Physical Therapist 225100000X CP053478T SC Primary
Physical Therapist 225100000X 16812 TN

Addresses

Primary practice location

2548 Cumberland Ave Ste 100
West Lafayette, IN 47906-4083

Mailing address

12788 Touchdown Dr
Fishers, IN 46037-9532
Phone (317) 544-8926

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brianna.clark.1@29985.direct.athenahealth.com Orthopaedics-Indianapolis, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260317002018 SC Practitioner - Physical Therapist in Private Practice 5092298166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthosc LLCGroup PAC ID 8022370030, 113 clinicians

Practice addresses (Care Compare)

103 Professional Park Dr
Conway, SC 29526-9261
Phone (843) 353-3460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05016133AINMDPhysical Therapist
CP053478TSCMDPhysical Therapist
CP048794TTNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthosc, LLC CurrentSince Feb 24, 2026 Accepting new patients
Orthosc, LLC CurrentSince Feb 24, 2026 Accepting new patients

Locations

103 Professional Park Dr
Conway, SC 29526
Phone (843) 335-3346

210 Village Center Blvd
Ste 100
Myrtle Beach, SC 29579
Phone (843) 491-4937

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17161/brand/1/csg/1/fhir/r4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1756080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1043198344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12788 TOUCHDOWN DR",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379532",
            "telephone_number": "317-544-8926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2548 CUMBERLAND AVE STE 100",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479064083",
            "telephone_number": "317-802-2000",
            "fax_number": "317-802-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BRIANNA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-25",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "CP048794T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05016133A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "CP053478T",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "16812",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brianna.clark.1@29985.direct.athenahealth.com",
            "affiliation": "Y",
            "endpointDescription": "Athena Address",
            "affiliationName": "Orthopaedics-Indianapolis, Inc",
            "address_1": "2548 Cumberland Ave Ste 100",
            "city": "West Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479064083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.