Emily Anderson Clark, PHYSICAL THERPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7611 Issued in CO

Practice address

2211 S College Ave
Suite 300
Fort Collins, CO 80525-1489

Phone

(970) 663-6142

Fax

(970) 635-3087

NPI assigned

Jul 31, 2006

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

Enrolled in CO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Rebound Sports & Physical Therapy, P.C.

  • Physical Therapist
  • Loveland, CO
  • NPI 1780680926

  CO, Physical Therapist

  Medicare reassignment Care Compare group NPD

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rebound Sports and Physical Therapy P.C 21 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1528074580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W 29TH ST",
            "address_2": "SUITE 100",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805382797",
            "telephone_number": "970-663-6142",
            "fax_number": "970-635-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 S COLLEGE AVE",
            "address_2": "SUITE 300",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251489",
            "telephone_number": "970-663-6142",
            "fax_number": "970-635-3087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "EMILY",
        "middle_name": "ANDERSON",
        "credential": "PHYSICAL THERPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "7611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caden Harvey Clark
• Carley Marie Clark, LCSW
• Carly Clark
• Carol W Clark, RN, BSN
• Clifford D Clark, M.D.
• Gregory P Clark, APN
• Hannah Galloway Clark, AU.D
• James Michael Clark, CRNA
• Jennifer Ann Clark, SLP
• Joann Clark, PT

• All providers in Fort Collins, CO
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.