Carrie Leigh Clark, MS, PT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

PT007762 Issued in GA

Practice address

7985 Knight Rd
Gainesville, GA 30506-6427

Phone

(770) 781-4899

NPI assigned

May 17, 2010

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walker Therapy Services

  • Occupational Therapist
  • Gainesville, GA
  • NPI 1679523302
  NPD (past)

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274054400000",
    "number": "1295054138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7535 BEECHWOOD LN",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305067043",
            "telephone_number": "770-887-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7985 KNIGHT RD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305066427",
            "telephone_number": "770-781-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CARRIE",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "MS, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-17",
        "last_updated": "2010-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "GA",
            "license": "PT007762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rudolf W Cisco, DPM
• Isabel Annaly Cisneros
• City of Gainesville
• Nathan Drew City, D.O.
• Misty Mullins Clackum, RD, CSP, LDN
• Hailey Clark
• Kara Schneider Clark, FNP-C
• Lillee Clark, PH.D.
• Mark D Clark, FNP
• Mykiah Clark

• Pediatric Physical Therapist in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Pediatric Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2010; 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.