Clark Physical Therapy, P.C.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

024340 Issued in NY

Legal business name

CLARK PHYSICAL THERAPY, P.C.

Practice address

2115 Empire Blvd
Webster, NY 14580-1907

Phone

(585) 267-9547

NPI assigned

Aug 1, 2017

Organization subpart

No

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

Authorized official

Name

Jamie ClarkNPI 1265962617

Title

Owner

Phone

(585) 267-9547

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jamie Albert Clark, PT

  • Sports Physical Therapist
  • Webster, NY
  • NPI 1265962617
  Medicare reassignment Care Compare group Authorized official
• Kimberley Ann Clark, PT

  • Physical Therapist
  • Canandaigua, NY
  • NPI 1225280886
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510272000000",
    "number": "1124542170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 PRINCETON LN",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144509027",
            "telephone_number": "585-267-9547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 EMPIRE BLVD",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145801907",
            "telephone_number": "585-267-9547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-01",
        "last_updated": "2017-11-10",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-267-9547"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "NY",
            "license": "024340",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "024340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Dawn Chirdon, LPN
• Kristen M Christian, MD
• Allison Ann Cima, FNP
• Cameryn Dominique Cimino, LMHC
• Dominic J Cirillo, M.D., PH.D.
• Jamie Albert Clark, PT
• Laura A Clark, MS, CCC/SLP
• Sharon Sandquist Clark, RPH
• Tierney Clark
• Catherine Ae Clauss, LCAT, ATR-BC

• Physical Therapy Clinic/Center in Webster, NY
• Providers in Webster, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.