Kristine Julia Clark, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT008605 Issued in GA

Practice address

809 N Patterson St
Valdosta, GA 31601-4528

Phone

(229) 469-6932

Fax

(229) 469-6933

NPI assigned

Nov 7, 2022

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

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 and National Provider Directory roles.

• Amerimed Therapy

  • Speech-Language Pathologist
  • Valdosta, GA
  • NPI 1750770970
  NPD

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1366150591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316014528",
            "telephone_number": "229-469-6932",
            "fax_number": "229-469-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316014528",
            "telephone_number": "229-469-6932",
            "fax_number": "229-469-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KRISTINE",
        "middle_name": "JULIA",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT008605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christa L Crawford LCSW PC
• Jennetta M Christie, M.D.
• Hunter L Clanton, FNP-C
• Ashlyn Clark
• Keyiarra Clark
• Michael Allen Clark, M.D.
• Ronika Clark
• Veronica Elizabeth Clark, PHARMD
• Clear Point Therapeutic Services LLC
• Chloe Clements, OTR/L

• Occupational Therapist in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.