Tracey A Clifford, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT01250 Issued in RI

Practice address

721 Reservoir Ave
Cranston, RI 02910-4430

Phone

(401) 946-4250

Fax

(401) 275-5645

NPI assigned

Jun 25, 2009

Last updated

Jun 25, 2009By the provider in NPPES

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

Other names 1

• Miss Tracey A Dufresne Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245888000000",
    "number": "1427286624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 RESERVOIR AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029104430",
            "telephone_number": "401-946-4250",
            "fax_number": "401-275-5645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 RESERVOIR AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029104430",
            "telephone_number": "401-946-4250",
            "fax_number": "401-275-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFFORD",
        "first_name": "TRACEY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT01250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "DUFRESNE",
            "middle_name": "A",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michelle C Clark, MSPT
• Natalie B Clark, MSW, LICSW, LCDP
• Clayton G. Hazelton DMD PC
• Jenna Rose Clifford, CNM
• Jillian Patricia Clifford, APRN
• Virginia Clifford, LICSW
• Close to Home Nursing Care LLC
• Coastal Derm & Cosmetic Center, Inc
• Coastal Medical, Inc.
• Coastline Ambulance Services, LLC

• Physical Therapist in Cranston, RI
• Providers in Cranston, RI by specialty
• Physical Therapist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; 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.