Individual provider Active NPI

Deborah R Clarke, O.T.

  • Occupational Therapist
  • Bismarck, ND
National Provider Identifier
1194700336
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
729 Issued in AZ
Practice address
310 North 9TH Street
Bismarck, ND 58502
Phone
(701) 530-8742
NPI assigned
Dec 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 729 AZ Primary

Addresses

Primary practice location

310 North 9TH Street
Bismarck, ND 58502

Mailing address

PO Box 1397
310 North 9TH Street
Bismarck, ND 58502-1397
Phone (701) 530-8742

Other identifiers 1

IdentifierTypeStateIssuer
747983MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060505000117 ND Practitioner - Occupational Therapist in Private Practice 8729092358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bone and Joint Center PCGroup PAC ID 3173416880, 40 clinicians

Practice addresses (Care Compare)

310 N 9TH St
Bismarck, ND 58501-4515
Phone (701) 946-7500

Merit-based Incentive Payment System (MIPS)

Final score
79.67 of 100Reported as group
Quality
80.89
Promoting interoperability
71
Improvement activities
40
Cost
75.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
970NDMDRehabilitation Chiropractor
0729AZMDFoot & Ankle Surgery Podiatrist
729AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bone & Joint Center PC Occupational Therapist CurrentSince Jan 10, 2006 Accepting new patients

Locations

310 N 9th St
Bismarck, ND 58501
Phone (701) 530-8800

Interoperability endpoints

  • Direct secure messaging: deborahclarke@tbjpc.allscriptsdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194700336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1397",
            "address_2": "310 NORTH 9TH STREET",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585021397",
            "telephone_number": "701-530-8742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 NORTH 9TH STREET",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58502",
            "telephone_number": "701-530-8742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "DEBORAH",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "747983",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.