Active NPI
Brittany Nicole Clark, OTR/L
- Occupational Therapist
- Dunn, NC
National Provider Identifier
1497212617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 12334
- Practice address
- 711 Susan Tart Rd
Dunn, NC 28334-5557 - Phone
- (910) 892-8843
- NPI assigned
- Feb 24, 2019
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 12334 | NC | Primary |
Addresses
Primary practice location
711 Susan Tart Rd
Dunn, NC 28334-5557
Mailing address
2023 Wickerleaf Way
Garner, NC 27529-9235
Phone (704) 301-2617
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12334 | NC | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550966400000",
"number": "1497212617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2023 WICKERLEAF WAY",
"city": "GARNER",
"state": "NC",
"postal_code": "275299235",
"telephone_number": "704-301-2617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 SUSAN TART RD",
"city": "DUNN",
"state": "NC",
"postal_code": "283345557",
"telephone_number": "910-892-8843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "BRITTANY",
"middle_name": "NICOLE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-24",
"last_updated": "2019-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "12334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dunn, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.