Michael R. Clark, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT1445 Issued in CA

Practice address

3327 M St Ste a
Merced, CA 95348-2714

Phone

(209) 722-1030

Fax

(209) 722-5408

NPI assigned

Jul 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Enrolled in CA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1996

Medicare assignment

May accept Medicare assignment

Group practices

Rascal Creek Physical Therapy a Professional Corporation.Group PAC ID 4981643632, 4 clinicians

Practice addresses (Care Compare)

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.

• Rascal Creek Physical Therapy a Professional Corporation.

  • Physical Therapy Clinic/Center
  • Merced, CA
  • NPI 1376575837
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316962384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3592 SANTA MARIA AVE",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953483570",
            "telephone_number": "209-383-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3327 M ST STE A",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953482714",
            "telephone_number": "209-722-1030",
            "fax_number": "209-722-5408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MICHAEL",
        "middle_name": "R.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT1445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Cisneros
• City of Merced
• Simren Claire, M.D.
• Christopher Clark, MD
• Dennis Eugene Clark, DDS
• Halle Clementi, PT
• Andrew Cline
• Lisa Suzanne Clinton, M.S.P.T.
• Sara Clinton, RN 684418
• Elizabeth Close

• Occupational Therapist in Merced, CA
• Providers in Merced, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.