Joel Clark I, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

0131000186 Issued in VA

Practice address

2003 Cobb St
Farmville, VA 23901-2603

Phone

(434) 391-6061

NPI assigned

Dec 17, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1387238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1104247212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 COBB ST",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239012603",
            "telephone_number": "434-391-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 COBB ST",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239012603",
            "telephone_number": "434-391-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JOEL",
        "name_suffix": "I",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-17",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131000186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Chandler, NP
• Judith Lynn Chantelois, MD
• Elizabeth Chassey, LPC
• Joe Chen
• Chest Diseases and Internal Medicine, P.C.
• Sherry Clark, LPC
• Clarks Pharmacy Inc
• Clearview Counseling PLLC
• Commonwealth of Virginia State Board of Health
• Commonwealth Pediatric Dentistry, PLLC

• Occupational Therapy Assistant in Farmville, VA
• Providers in Farmville, VA by specialty
• Occupational Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.