Kimberly Clark, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTH9722 Issued in AL

Practice address

3800 River Run Dr Ste 102
Mountain BRK, AL 35243-4719

Phone

(205) 970-2350

NPI assigned

Feb 6, 2020

Last updated

Aug 31, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kimberly Galloway Former name

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Therapy South Liberty Park LLC

  • Physical Therapist
  • Birmingham, AL
  • NPI 1730481029
  Medicare reassignment NPD

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1235761404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 GREYSTONE COMMERCIAL BLVD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352422660",
            "telephone_number": "205-745-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 RIVER RUN DR STE 102",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352434719",
            "telephone_number": "205-970-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KIMBERLY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-06",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH9722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PTH9722",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "GALLOWAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samantha Carter, ALC
• Miranda Lynnzey Casey, LICSW
• Amber Brooke Chesser, ALC
• Christine Le Psychology LLC
• Terpsithea N/a Christou, DDS
• Lauren Roberts Clark, LPC
• Amy Clemmons, LPC
• Jarvis T. Cleveland, LMSW
• Lynne Burton Clifton, LCSW-PIP
• Marion Yvonne Coleman, LPC

• Physical Therapist in Mountain BRK, AL
• Providers in Mountain BRK, AL by specialty
• Physical Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.