Active NPI
Emilee Clark, M.S.OTR/L
- Pediatric Occupational Therapist
- Mobile, AL
National Provider Identifier
1265771323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 3566
- Practice address
- 3043 Villa Dr
Mobile, AL 36695-9717 - Phone
- (251) 375-4879
- NPI assigned
- Feb 10, 2013
- Last updated
- Jun 20, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 3566 | AL | Primary |
Addresses
Primary practice location
3043 Villa Dr
Mobile, AL 36695-9717
Mailing address
3043 Villa Dr
Mobile, AL 36695-9717
Phone (251) 375-4879
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3566 | AL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403222400000",
"number": "1265771323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3043 VILLA DR",
"city": "MOBILE",
"state": "AL",
"postal_code": "366959717",
"telephone_number": "251-375-4879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3043 VILLA DR",
"city": "MOBILE",
"state": "AL",
"postal_code": "366959717",
"telephone_number": "251-375-4879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "EMILEE",
"name_prefix": "Mrs.",
"credential": "M.S.OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-02-10",
"last_updated": "2014-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "AL",
"license": "3566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.