Jessica Marling Clayton, DPT
Individual provider Active NPI Orthopedic Physical Therapist · Vidalia, LA
NPI 1154596377 · NPPES record last updated Jan 31, 2024
Key facts
- NPI
- 1154596377
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopedic Physical Therapist 2251X0800X
- License
- 09009R (LA)
- Practice address
- 4616 Highway 84 W
Vidalia, LA 71373-3357 - Phone
- (318) 336-5400
- Fax
- (318) 336-8621
- NPI assigned
- Apr 29, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Louisiana State University School of Medicine in Shreveport, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Core Physical Therapy, LLC
Practice addresses (Care Compare)
4616 Hwy 84 W
Vidalia, LA 71373-3357
Phone (318) 336-5400
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150309002235 | LA | Practitioner - Physical Therapist in Private Practice | 0941370621 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09009R | LA | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Core Physical Therapy, LLC | Current |
Accepting new patients | |
| Natchez Regional Clinic | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 09009R | LA | Yes |
Addresses
Primary practice location
4616 Highway 84 W
Vidalia, LA 71373-3357
Mailing address
4616 Highway 84 W
Vidalia, LA 71373-3357
Phone (318) 336-5400
Other practice location 1
46 Sgt Prentiss Dr
Suite 103
Natchez, MS 39120-4792
Phone (601) 442-9654
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 236280 | Medicaid | LA |
Other providers in Vidalia, LA
- Susan Chapman
- Chaque Femme Boutique LLC
- Cherry Blossom Care Agency, Inc
- Cheryl Clark
- Trumeka Clark
- Krystle Coleman
- Alexius Coley
- Concordia Parish Hospital Service District Number One
- Concordia Parish School Board
- Concordia Parish School Board
All providers in Vidalia, LA · Orthopedic Physical Therapist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.