Jordan Barton Clark, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP1347 Issued in AZ

Practice address

1462 S 231St LN
Buckeye, AZ 85326-6131

Phone

(623) 327-0931

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Therapy One, PLLC

  • Speech-Language Pathologist
  • Mesa, AZ
  • NPI 1316163884
  NPD

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679508345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1462 S 231ST LN",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853266131",
            "telephone_number": "623-327-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1462 S 231ST LN",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853266131",
            "telephone_number": "623-327-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JORDAN",
        "middle_name": "BARTON",
        "name_prefix": "Mr.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP1347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "644535",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adya Chaurasia
• Lynn Phan Chavez, PHARMD
• City of Buckeye
• Lindsey Jo Clapp, PTA
• Zarifa Clark-Hentz
• Patrick Thomas Clark
• Carrie Lee Clausen, SLPA
• Cle Creations
• Cle Creations
• Daniell E. Clingman

• Speech-Language Pathologist in Buckeye, AZ
• Providers in Buckeye, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.