Individual provider Active NPI

Sydne Justine Clark, M.S., OTR/L

  • Occupational Therapist
  • Owensboro, KY
National Provider Identifier
1629704630
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
276408 Issued in KY
Practice address
122 E 18TH St
Owensboro, KY 42303-3751
Phone
(270) 926-2212
Fax
(270) 926-2215
NPI assigned
Aug 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 276408 KY Primary

Addresses

Primary practice location

122 E 18TH St
Owensboro, KY 42303-3751

Mailing address

122 E 18TH St
Owensboro, KY 42303-3751
Phone (270) 926-2212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260112001354 KY Practitioner - Occupational Therapist in Private Practice 3577049352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carrico Therapy Services LLCGroup PAC ID 7012243470, 3 clinicians

Practice addresses (Care Compare)

122 E 18TH St
Owensboro, KY 42303-3751
Phone (270) 926-2212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
276408KYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carrico Therapy Services LLC Occupational Therapist CurrentSince Jan 7, 2026 Accepting new patients
Theratree, LLC. Occupational Therapist CurrentSince Aug 7, 2022 Accepting new patients

Locations

122 E 18th St
Owensboro, KY 42303
Phone (270) 926-2212

2605 New Hartford Rd
Owensboro, KY 42303
Phone (270) 688-8449

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.

NPI Registry JSON

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1629704630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E 18TH ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423033751",
            "telephone_number": "270-926-2212",
            "fax_number": "270-926-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 E 18TH ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423033751",
            "telephone_number": "270-926-2212",
            "fax_number": "270-926-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SYDNE",
        "middle_name": "JUSTINE",
        "credential": "M.S., OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-01",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "276408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.