Austin Hope Clark
Individual provider Active NPI Occupational Therapist · Masonic Home, KY
NPI 1619680550 · NPPES record last updated Jan 9, 2023
Key facts
- NPI
- 1619680550
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 282488 (KY)
- Practice address
- 3761 Johnson Hall Dr
Masonic Home, KY 40041-9998 - Phone
- (502) 293-1696
- NPI assigned
- Jan 5, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 27
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Empowerme Rehabilitation Kentucky, LLC
Healthpro Heritage Rehab and Fitness LLC
Practice addresses (Care Compare)
1165 Monarch St
Lexington, KY 40513-1979
Phone (844) 502-7996
4600 Bowling Blvd
Louisville, KY 40207-5155
Phone (502) 200-9264
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240305000206 | KY | Practitioner - Occupational Therapist in Private Practice | 7315382017 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 282488 | KY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthpro Heritage Rehab & Fitness, LLC | Occupational Therapist | Current |
Accepting new patients |
| Empowerme Rehabilitation Kentucky, LLC | Current |
Accepting new patients | |
| Healthpro Heritage Rehab & Fitness, LLC | Occupational Therapist | Current |
Accepting new patients |
| Empowerme Rehabilitation Kentucky, LLC | Occupational Therapist | Current |
Accepting new patients |
Locations
1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 282488 | KY | Yes |
Addresses
Primary practice location
3761 Johnson Hall Dr
Masonic Home, KY 40041-9998
Mailing address
90 Howard Dr
Shelbyville, KY 40065-8138
Other providers in Masonic Home, KY
- Assocaites in Pediatric Therapy LLC
- Morgan Boyd
- Jamie Kathryn Brake
- Shannon Carty-Janis
- Morgan Kaye Chambliss
- Jolie Dandurand
- Mackenzie Dial
- Kylie Rae Dombrosky
- Fresenius Medical Care Masonic Homes, LLC
- Ivonne Gonzalez Hermosillo
All providers in Masonic Home, KY · Occupational Therapist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.