Nathan Clarke

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

26573 Issued in MA

Practice address

64J Concord St
Wilmington, MA 01887-2179

Phone

(781) 935-7701

NPI assigned

Nov 29, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athletic Evolution Physical Therapy LLCGroup PAC ID 2163785221, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Athletic Evolution Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Woburn, MA
  • NPI 1346744216
  Medicare reassignment Care Compare group
• Athletic Evolution Strength and Conditioning, Inc

  • Physical Medicine & Rehabilitation Physician
  • Woburn, MA
  • NPI 1538987953

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1669680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1043920218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64J CONCORD ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018872179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64J CONCORD ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018872179",
            "telephone_number": "781-935-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "NATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-29",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "26573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Chin, RD
• Chirocare Associates, PC
• Rolen Chom
• Alan Kho Chua
• Emily Ciulla
• Danielle Coakley
• James Coates
• Adam Colella
• Stacy Coletti
• Hannah Colizzi

• Physical Therapist in Wilmington, MA
• Providers in Wilmington, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.