Adam Thomas Clark, PT, DPT, OCS, COMT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

5501018297 Issued in MI

Practice address

2591 44TH St SE Ste 101
Grand Rapids, MI 49512-9094

Phone

(616) 281-9237

Fax

(616) 281-3115

NPI assigned

Jul 27, 2017

Last updated

Oct 25, 2022By the provider in NPPES

Sex

Male

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

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Center for Physical Rehabilitation and Therapy LP

  • Physical Therapy Clinic/Center
  • Grand Rapids, MI
  • NPI 1902288863

  Physical Therapist

  Medicare reassignment NPD
• Physiotherapy Associates Inc

  dba NovaCare Rehabilitation

  • Rehabilitation Clinic/Center
  • Grand Rapids, MI
  • NPI 1588775373
  NPD (past)
• Physiotherapy Associates, Inc.

  dba NovaCare Rehabilitation

  • Rehabilitation Clinic/Center
  • Battle Creek, MI
  • NPI 1023124823
  NPD (past)

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1083138473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2591 44TH ST SE STE 101",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495129094",
            "telephone_number": "502-489-5002",
            "fax_number": "616-281-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2591 44TH ST SE STE 101",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495129094",
            "telephone_number": "616-281-9237",
            "fax_number": "616-281-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ADAM",
        "middle_name": "THOMAS",
        "credential": "PT, DPT, OCS, COMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-27",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "007201",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MI",
            "license": "5501018297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clark Retirement Community Inc. (Clark at Home Health Services)
• Clark Retirement Community, Inc.
• Clark Retirement Pharmacy
• Susan Lynn Clark-Granger, LMSW
• Chiquita Vondel Clark-Macklin
• Alysa Michelle Clark, MD
• Amanda Elizabeth Clark, BS, QIDP
• Austin J Clark, PA
• Carrie Hoogerhyde Clark, DO
• Cassidy Leigh Clark, DO

• Orthopedic Physical Therapist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Orthopedic Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.