Individual provider Active NPI

William Warren Clark, CTRS

  • Recreation Therapist
  • Temple, TX
National Provider Identifier
1124320692
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Recreation TherapistTaxonomy code 225800000X
Practice address
2118 Stagecoach TRL
Temple, TX 76502-3224
Phone
(254) 931-9531
NPI assigned
Dec 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Recreation Therapist 225800000X Primary

Addresses

Primary practice location

2118 Stagecoach TRL
Temple, TX 76502-3224

Mailing address

2118 Stagecoach TRL
Temple, TX 76502-3224
Phone (254) 931-9531

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

NPI Registry JSON

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291334400000",
    "number": "1124320692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 STAGECOACH TRL",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765023224",
            "telephone_number": "254-931-9531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 STAGECOACH TRL",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765023224",
            "telephone_number": "254-931-9531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "WILLIAM",
        "middle_name": "WARREN",
        "credential": "CTRS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-03",
        "last_updated": "2010-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; 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.