Active NPI
Beth A Clark, D.P.T.
- Physical Therapist
- Hayward, WI
National Provider Identifier
1447489083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 15735 W US Highway 63
Hayward, WI 54843-6475 - Phone
- (888) 834-4551
- Fax
- (715) 598-4881
- NPI assigned
- Jul 3, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
15735 W US Highway 63
Hayward, WI 54843-6475
Mailing address
N757 Big Kegama Rd
Sarona, WI 54870-9037
Phone (715) 651-1838
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090806000491 | WI | Practitioner - Physical Therapist in Private Practice | 8022161165 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeview Medical Center Inc of Rice Lake | Current | Accepting new patients | |
| Lakeview Medical Center Inc of Rice Lake | Current | Accepting new patients |
Locations
1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111
1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133
1035 N Main St
Rice Lake, WI 54868
Phone (715) 234-4313
Organizations & group practices 3
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.
-
- Home Health Agency
- Rice Lake, WI
- NPI 1326139049
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685404800000",
"number": "1447489083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N757 BIG KEGAMA RD",
"city": "SARONA",
"state": "WI",
"postal_code": "548709037",
"telephone_number": "715-651-1838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15735 W US HIGHWAY 63",
"city": "HAYWARD",
"state": "WI",
"postal_code": "548436475",
"telephone_number": "888-834-4551",
"fax_number": "715-598-4881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "BETH",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-03",
"last_updated": "2023-05-30",
"certification_date": "2023-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayward, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.