Elizabeth Lee Clark

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OP003489L Issued in PA

Practice address

213 E Main St
New Bloomfield, PA 17068-9657

Phone

(717) 582-0054

NPI assigned

Feb 2, 2013

Last updated

Feb 2, 2013By 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

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": "1359763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359763200000",
    "number": "1508105180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3081 STONE ARCH RD",
            "city": "NEWPORT",
            "state": "PA",
            "postal_code": "170748008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 E MAIN ST",
            "city": "NEW BLOOMFIELD",
            "state": "PA",
            "postal_code": "170689657",
            "telephone_number": "717-582-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ELIZABETH",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-02",
        "last_updated": "2013-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "PA",
            "license": "OP003489L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in New Bloomfield, PA
• Providers in New Bloomfield, PA by specialty
• Occupational Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2013; 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.