William D Clark, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA0019161 Issued in FL

Practice address

1160 Lucerne Loop Rd NE
Winter Haven, FL 33881-9681

Phone

(863) 287-6960

NPI assigned

Feb 4, 2011

Sex

Male

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

• Mr. William D Clark Other name

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.

{
    "created_epoch": "1296777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296777600000",
    "number": "1487950606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 LUCERNE LOOP RD NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338819681",
            "telephone_number": "863-287-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 LUCERNE LOOP RD NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338819681",
            "telephone_number": "863-287-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "WILLIAM",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-04",
        "last_updated": "2011-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA0019161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLIAM",
            "last_name": "CLARK",
            "middle_name": "D",
            "prefix": "MR.",
            "credential": "LMT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joseph F Ciarlante, PTA
• Ediberto Cicilio, MD
• Kristen Clark
• Krysta Ann Clark, NP
• Wendy Marie Clark, APRN
• Mary Beth Claypool
• Clearmedica Medical Centers, LLC
• George Bruce Clement, MD.
• Safaa Clermont
• Virginia Clifford, ARNP

• Massage Therapist in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2011; 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.