Active NPI
Rebecca Swint Clark, CTRS
- Recreation Therapist
- Dublin, GA
National Provider Identifier
1568059574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 50666
- Practice address
- 1826 Veterans Blvd
Dublin, GA 31021-3620 - Phone
- (478) 272-1210
- NPI assigned
- Dec 23, 2020
- Last updated
- Dec 23, 2020
- 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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 50666 | GA | Primary |
Addresses
Primary practice location
1826 Veterans Blvd
Dublin, GA 31021-3620
Mailing address
1826 Veterans Blvd
Dublin, GA 31021-3620
Phone (478) 272-1210
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 |
|---|---|---|---|
| 50666 | GA | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608681600000",
"number": "1568059574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1826 VETERANS BLVD",
"city": "DUBLIN",
"state": "GA",
"postal_code": "310213620",
"telephone_number": "478-272-1210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1826 VETERANS BLVD",
"city": "DUBLIN",
"state": "GA",
"postal_code": "310213620",
"telephone_number": "478-272-1210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "REBECCA",
"middle_name": "SWINT",
"name_prefix": "Mrs.",
"credential": "CTRS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-23",
"last_updated": "2020-12-23",
"certification_date": "2020-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "GA",
"license": "50666",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dublin, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.