Joy D Clark, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

00719 Issued in IA

Practice address

2855 SW Vintage Parkway
Ankeny, IA 50023

Phone

(515) 481-5503

NPI assigned

Sep 23, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Joy D Nelson 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": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1104643014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 ORCHARD HILLS DR",
            "city": "NORWALK",
            "state": "IA",
            "postal_code": "502119783",
            "telephone_number": "515-953-8167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 SW VINTAGE PARKWAY",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "50023",
            "telephone_number": "515-481-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JOY",
        "middle_name": "D",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IA",
            "license": "00719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOY",
            "last_name": "NELSON",
            "middle_name": "D",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julia Madalena Civettini
• Cabrie Joylyn Claiser
• Craig Steven Clark, LMHC
• Danielle Jo Clark, LISW
• Gregory James Clark, MD
• Leah Jean Clark, LMSW
• Sarah Elizabeth Clark, ARNP, PMHNP-BC
• Jessica S Clausen, LISW
• Alyssa Clayden, PHD, LISW
• Clean Slate Counseling

• All providers in Ankeny, IA
• Occupational Therapy Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.