Active NPI
William O. Clark, LMT
- Massage Therapist
- Salt Lake City, UT
National Provider Identifier
1679355341
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Oct 20, 2025.
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 9740409-4701
- Practice address
- 1174 E Graystone Way Ste 20G
Salt Lake City, UT 84106-2678 - Phone
- (801) 793-9435
- NPI assigned
- Oct 18, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 9740409-4701 | UT | Primary |
Addresses
Primary practice location
1174 E Graystone Way Ste 20G
Salt Lake City, UT 84106-2678
Mailing address
2979 W 3835 S
West Valley, UT 84119-4557
Phone (801) 793-9435
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9740409-4701 | UT | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697587200000",
"number": "1679355341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2979 W 3835 S",
"city": "WEST VALLEY",
"state": "UT",
"postal_code": "841194557",
"telephone_number": "801-793-9435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1174 E GRAYSTONE WAY STE 20G",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841062678",
"telephone_number": "801-793-9435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "WILLIAM",
"middle_name": "O.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-10-18",
"last_updated": "2023-10-18",
"certification_date": "2023-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "UT",
"license": "9740409-4701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.