Active NPI
Abbie Clark, DPT
- Physical Therapist
- Bradford, PA
National Provider Identifier
1679200075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT030767
- Practice address
- 100 Saint Francis Dr
Bradford, PA 16701-1868 - Phone
- (814) 368-5648
- NPI assigned
- Aug 4, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | |||
| Physical Therapist | 225100000X | PT030767 | PA | Primary |
Addresses
Primary practice location
100 Saint Francis Dr
Bradford, PA 16701-1868
Mailing address
100 Saint Francis Dr
Bradford, PA 16701-1868
Phone (814) 368-5648
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 |
|---|---|---|---|
| PT030767 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708992000000",
"number": "1679200075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 SAINT FRANCIS DR",
"city": "BRADFORD",
"state": "PA",
"postal_code": "167011868",
"telephone_number": "814-368-5648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 SAINT FRANCIS DR",
"city": "BRADFORD",
"state": "PA",
"postal_code": "167011868",
"telephone_number": "814-368-5648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "ABBIE",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-04",
"last_updated": "2024-02-27",
"certification_date": "2024-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT030767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bradford, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.