Active NPI
James Butch Clark, PT
- Physical Therapist
- The Villages, FL
National Provider Identifier
1609005107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 38587
- Practice address
- 1050 Old Camp Rd Suite 282
The Villages, FL 32162 - Phone
- (417) 576-3998
- NPI assigned
- Jul 7, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT3159 | AR | |
| Physical Therapist | 225100000X | 38587 | FL | Primary |
Addresses
Primary practice location
1050 Old Camp Rd Suite 282
The Villages, FL 32162
Mailing address
11962 County Rd 101
Suite 104
The Villages, FL 32162
Phone (352) 254-3368
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 |
|---|---|---|---|
| PT3159 | AR | MD | Physical Therapist |
| 38587 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jordan Physical Therapy Center LLC | Physical Therapist | Past | Accepting new patients |
| Hot Springs Comprehensive Therapy Services LLC | Physical Therapist | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
Organizations & group practices 2
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.
-
- Physical Therapist
- Hot Springs, AR
- NPI 1710267802
-
- Physical Therapist
- Hot Springs, AR
- NPI 1083681530
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1609005107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11962 COUNTY RD 101",
"address_2": "SUITE 104",
"city": "THE VILLAGES",
"state": "FL",
"postal_code": "32162",
"telephone_number": "352-254-3368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 OLD CAMP RD SUITE 282",
"city": "THE VILLAGES",
"state": "FL",
"postal_code": "32162",
"telephone_number": "417-576-3998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JAMES",
"middle_name": "BUTCH",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-07",
"last_updated": "2022-09-12",
"certification_date": "2022-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "PT3159",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "38587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in The Villages, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.