Ashley Victoria Clark, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA004397 Issued in GA

Practice address

500 Springhouse Cir
Stone Mountain, GA 30087-6741

Phone

(678) 684-3800

NPI assigned

Apr 5, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ashley Victoria West Former name

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1083355796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1274 ELMHURST CIR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303162726",
            "telephone_number": "404-494-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SPRINGHOUSE CIR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300876741",
            "telephone_number": "678-684-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ASHLEY",
        "middle_name": "VICTORIA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA004397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "WEST",
            "middle_name": "VICTORIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Sasha-Ann L Cisneros
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• Alasia Clinton

• Physical Therapy Assistant in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.