Makayla Clarke, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

00397 Issued in RI

Practice address

19 Lady Slipper TRL
Charlestown, RI 02813-3414

Phone

(401) 474-7500

NPI assigned

Oct 24, 2016

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

State licenses

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1073064119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 662",
            "city": "CHARLESTOWN",
            "state": "RI",
            "postal_code": "028130662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 LADY SLIPPER TRL",
            "city": "CHARLESTOWN",
            "state": "RI",
            "postal_code": "028133414",
            "telephone_number": "401-474-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "MAKAYLA",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "RI",
            "license": "00397",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CT",
            "license": "001031",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Casci, D.O.
• Teresa M Castagna, LCSW
• Alice M Cesana, MA, LMHC
• Charlestown Ambulance & Rescue Service, Inc.
• Charlestown Physical Therapy and Health Services LLC
• Cindy Marie Coite, LICSW
• Elyse Connolly
• Stuart Demirs, M.D.
• Sarah Ladd Dennewitz, M.S., MFT
• Kailynn Deoliveira, LCDP

• Athletic Trainer in Charlestown, RI
• Providers in Charlestown, RI by specialty
• Athletic Trainer in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.