Active NPI
Leslie Clark, PT
- Physical Therapist
- Wilmington, NC
National Provider Identifier
1154677011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8282
- Practice address
- 2744 S 17TH St
Wilmington, NC 28412-6606 - Phone
- (910) 338-0435
- NPI assigned
- Jul 30, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 8282 | NC | Primary |
Addresses
Primary practice location
2744 S 17TH St
Wilmington, NC 28412-6606
Mailing address
7235 Masonboro Sound Rd
Wilmington, NC 28409-2949
Phone (910) 612-3065
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343606400000",
"number": "1154677011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7235 MASONBORO SOUND RD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284092949",
"telephone_number": "910-612-3065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2744 S 17TH ST",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284126606",
"telephone_number": "910-338-0435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "LESLIE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-30",
"last_updated": "2012-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "8282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.