Clark Fitness Training, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

40QA01506500 Issued in NJ

Legal business name

CLARK FITNESS TRAINING, LLC

Practice address

60 Tilton Dr
Freehold, NJ 07728-3360

Phone

(732) 771-3343

Fax

(732) 625-7867

NPI assigned

Oct 10, 2013

Last updated

Jun 3, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Anne Clark, DPTNPI 1780019802

Title

President/Owner

Phone

(732) 771-3343

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anne Marie Clark, DPT

  • Physical Therapist
  • Red Bank, NJ
  • NPI 1780019802
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1629405568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 TILTON DR",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077283360",
            "telephone_number": "732-771-3343",
            "fax_number": "732-625-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 TILTON DR",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077283360",
            "telephone_number": "732-771-3343",
            "fax_number": "732-625-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK FITNESS TRAINING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-10",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "732-771-3343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QA01506500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Citadel at Home LLC (Citadel Home Care)
• Cje Hospitalist Associates LLC
• CK Surgical, LLC
• Claim Path New Jersey, LLC
• Liza R. Clancy, MSW, LCSW
• Clark Institute
• Cierra Florentina Clark, LPC
• Lauren Clark, BCBA
• Katerina Clayton, DO
• Kerianne Joan Clayton, LSW

• Physical Therapy Clinic/Center in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.