Individual provider Active NPI

Chelsea Beth Phillips Claybrook, PTA

  • Physical Therapy Assistant
  • Fort Smith, AR
National Provider Identifier
1104175280
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA 2617 Issued in AR
Practice address
1801 South 74TH St.
Fort Smith, AR 72904
Phone
(479) 478-5577
Fax
(479) 478-5560
NPI assigned
Sep 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA 2617 AR Primary

Addresses

Primary practice location

1801 South 74TH St.
Fort Smith, AR 72904

Mailing address

1801 South 74TH St.
Fort Smith, AR 72904
Phone (479) 478-5577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA 2617ARMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1104175280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 SOUTH 74TH ST.",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "72904",
            "telephone_number": "479-478-5577",
            "fax_number": "479-478-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SOUTH 74TH ST.",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "72904",
            "telephone_number": "479-478-5577",
            "fax_number": "479-478-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS CLAYBROOK",
        "first_name": "CHELSEA",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "PTA 2617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; 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.