Gayle Clark, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA002352 Issued in OH

Practice address

5440 Charlesgate Rd
Huber Heights, OH 45424-1049

Phone

(937) 236-6770

NPI assigned

Jun 24, 2024

Sex

Female

Sole proprietor

No

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, last updated by the provider on Jun 24, 2024.

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1366286353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 CHARLESGATE RD",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454241049",
            "telephone_number": "937-236-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 CHARLESGATE RD",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454241049",
            "telephone_number": "937-236-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "GAYLE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA002352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connie Chin, MD
• Gail Christian
• Elmira Chukadze, CNP
• Jonathan Jeffrey Ciesla, DOCTOR OF PHARMACY
• City of Huber Heights
• Clarks RX LLC
• Joshua Stephen Clemons, CPRS
• CML Foods LTD
• Kayla D Coates, RBT
• Nicole Cobb

• All providers in Huber Heights, OH
• Occupational Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.