Active NPI
Melissa Lynn Clarke, OTR/L
- Occupational Therapist
- Waukon, IA
National Provider Identifier
1194957738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 001975
- Practice address
- 40 1St St SE
Waukon, IA 52172-2022 - Phone
- (563) 419-3592
- NPI assigned
- Aug 16, 2009
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 001975 | IA | Primary |
Addresses
Primary practice location
40 1St St SE
Waukon, IA 52172-2022
Mailing address
P.O. Box 66
Castalia, IA 52133
Phone (563) 419-3592
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250380800000",
"number": "1194957738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 66",
"city": "CASTALIA",
"state": "IA",
"postal_code": "52133",
"telephone_number": "563-419-3592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 1ST ST SE",
"city": "WAUKON",
"state": "IA",
"postal_code": "521722022",
"telephone_number": "563-419-3592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARKE",
"first_name": "MELISSA",
"middle_name": "LYNN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-16",
"last_updated": "2009-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IA",
"license": "001975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukon, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.