Carol Shelby Clark, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3421 Issued in TN

Practice address

1647 Mallory LN
Suite 103
Brentwood, TN 37027-2909

Phone

(615) 661-5437

Fax

(615) 277-2838

NPI assigned

Jul 6, 2006

Sex

Female

Sole proprietor

No

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

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.

• High Hopes, Inc.

  • Pediatric Physical Therapist
  • Franklin, TN
  • NPI 1861675084

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240876800000",
    "number": "1053343681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 LAWN VIEW LN",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370645566",
            "telephone_number": "901-299-0669",
            "fax_number": "615-595-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1647 MALLORY LN",
            "address_2": "SUITE 103",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272909",
            "telephone_number": "615-661-5437",
            "fax_number": "615-277-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CAROL",
        "middle_name": "SHELBY",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2009-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "3421",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TN",
            "license": "3421",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Paige Clanton, MSN, APN, A/GNP-BC
• Emma Clapp
• Sara Clapp
• Clark & Sanchez Health Center LLC
• Ashley Nutt Clark, NP
• Christian Clark
• Jennie Claire Clark
• Jesse Clark, CNIM
• Jessie F Clark
• Riley Clark, MS, CCC-SLP

• Occupational Therapist in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Occupational Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; 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.