Vanessa Young Clark, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

03158 Issued in LA

Practice address

12047 Lake Estates Ave
Baton Rouge, LA 70810-7323

Phone

(225) 761-0828

NPI assigned

Sep 20, 2013

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 names 1

• Ms. Vanessa Faye Young Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1265868368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12047 LAKE ESTATES AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708107323",
            "telephone_number": "225-761-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12047 LAKE ESTATES AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708107323",
            "telephone_number": "225-761-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "VANESSA",
        "middle_name": "YOUNG",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-20",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "03158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "YOUNG",
            "middle_name": "FAYE",
            "prefix": "MS.",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert Austin Clark, MD
• Roshonna Clark
• Sandra B Clark, CRNA
• Simon Clark, D.O.
• Suzanne Jones Clark, APRN, LPC
• Raymond Clarke
• Bailey Noel Clary
• Hope Wakefield Clary, NP
• Harold George Clausen, MD
• Joni Nicole Claville, M.D.

• Physical Therapist in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.