Jamie Albert Clark, PT

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

024340 Issued in NY

Practice address

2115 Empire Blvd
Webster, NY 14580-1907

Phone

(585) 267-9547

NPI assigned

Jun 19, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clark Physical Therapy PCGroup PAC ID 3678838323, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Clark Physical Therapy, P.C.

  • Physical Therapy Clinic/Center
  • Webster, NY
  • NPI 1124542170
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1265962617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 PRINCETON LN",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144509027",
            "telephone_number": "585-267-9547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 EMPIRE BLVD",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145801907",
            "telephone_number": "585-267-9547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1671 Penfield Rd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146252568",
            "country_code": "US",
            "telephone_number": "585-267-9547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JAMIE",
        "middle_name": "ALBERT",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NY",
            "license": "024340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen M Christian, MD
• Allison Ann Cima, FNP
• Cameryn Dominique Cimino, LMHC
• Dominic J Cirillo, M.D., PH.D.
• Clark Physical Therapy, P.C.
• Laura A Clark, MS, CCC/SLP
• Sharon Sandquist Clark, RPH
• Tierney Clark
• Catherine Ae Clauss, LCAT, ATR-BC
• Jennifer M. Clegg, MS, PT

• Sports Physical Therapist in Webster, NY
• Providers in Webster, NY by specialty
• Sports Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.