Individual provider Active NPI

Urian Clark, DPT

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1477364545
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017539 Issued in GA
Practice address
260 Peachtree St NW Ste 2200
Atlanta, GA 30303-1292
Phone
(866) 839-6979
Fax
(916) 913-5646
NPI assigned
Jan 16, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05013956A IN
Physical Therapist 225100000X 40QA02232200 NJ
Physical Therapist 225100000X 070025427 IL
Physical Therapist 225100000X PT017539 GA Primary

Addresses

Primary practice location

260 Peachtree St NW Ste 2200
Atlanta, GA 30303-1292

Mailing address

260 Peachtree St NW Ste 2200
Atlanta, GA 30303-1292
Phone (866) 839-6979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250205000885 GA Practitioner - Physical Therapist in Private Practice 1052841186 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070025427ILMDPhysical Therapist
05013956AINMDPhysical Therapist
40QA02232200NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Luna Care Physical Therapy LLC Physical Therapist CurrentSince Jan 17, 2025 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Jan 31, 2025 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Jan 31, 2025 Accepting new patients
Emory Physical Therapy, LLC Current Accepting new patients

Locations

21 Ortho Ln
Atlanta, GA 30329
Phone (404) 778-2516

260 Peachtree St NW
Ste 2200
Atlanta, GA 30303
Phone (669) 231-6870

1845 Satellite Blvd
Ste 750
Duluth, GA 30097
Phone (404) 778-6490

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1477364545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 PEACHTREE ST NW STE 2200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303031292",
            "telephone_number": "866-839-6979",
            "fax_number": "916-913-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 PEACHTREE ST NW STE 2200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303031292",
            "telephone_number": "866-839-6979",
            "fax_number": "916-913-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "URIAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013956A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02232200",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070025427",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT017539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.

Verify at the official NPI Registry.