Robert H Clarke II, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA10913 Issued in FL

Practice address

1166 SW Goodman Ave
Port St Lucie, FL 34953-1433

Phone

(305) 785-3504

NPI assigned

Jun 22, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• One Faith Therapy Inc.

  • Physical Therapist
  • Port Saint Lucie, FL
  • NPI 1699560391
  Medicare reassignment NPD
• Robert's Rehab Services, LLC

  • Physical Medicine & Rehabilitation Physician
  • Port St Lucie, FL
  • NPI 1710660493

  Occupational Therapy Assistant

  NPD Authorized official

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1174209399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1166 SW GOODMAN AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349531433",
            "telephone_number": "305-785-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1166 SW GOODMAN AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349531433",
            "telephone_number": "305-785-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "ROBERT",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA10913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walner Cius
• Janice Clacken
• Soline Clairvoyant
• Jessica Lynn Clark, MA/CAGS
• Jordan Shaye Clark, DC
• Vivette Clarke
• Diana Isabel Clavijo
• Sarah Clay, CNM
• Stacey Cleary
• Christina Raffa Clements

• Occupational Therapy Assistant in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Occupational Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.