Jessica Taylor Clark, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT014643 Issued in GA

Practice address

800 Peachtree St NE Ste E2
Atlanta, GA 30308-1245

Phone

(404) 254-3319

Fax

(404) 600-6092

NPI assigned

Aug 3, 2020

Last updated

Aug 3, 2020By 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

Other names 1

• Jessica Taylor Moss Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1538779814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PEACHTREE ST NE STE E2",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303081245",
            "telephone_number": "404-254-3319",
            "fax_number": "404-600-6092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JESSICA",
        "middle_name": "TAYLOR",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MOSS",
            "middle_name": "TAYLOR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Andrew Clark, M.D.
• Janelle Clark
• Jason A Clark, M.D.
• Javeya Clark, OD
• Jeffrey Ira Clark, MD
• Johanna J Clark, CSA
• Julia Clark, LMSW
• Kathleen Linton Clark, APRN-BC
• Kathy Clark, CAT
• Kimberly Anne Clark, RBT

• Physical Therapist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.