Julie Clark, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

006162 Issued in CT

Practice address

1111 Stratford Ave Apt 319
Stratford, CT 06615-6379

Phone

(475) 473-9955

NPI assigned

Jul 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Agewell Rehab Services PLLCGroup PAC ID 1850735226, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Agewell Rehab Services PLLC

  • Occupational Therapist
  • Stratford, CT
  • NPI 1033989116

  CT, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Happy Steps Therapy PLLC

  • Occupational Therapist
  • Stratford, CT
  • NPI 1235971722
  NPD
• Foot & Ankle Physical Therapy & Rehab Medicine

  • Physical Therapist
  • Milford, CT
  • NPI 1164591459
  NPD (past)
• Milford Podiatry Associates PC

  • Ambulatory Surgical Clinic/Center
  • Milford, CT
  • NPI 1184788861
  NPD (past)

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730592000000",
    "number": "1679599229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 NEW HAVEN AVE",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064606661",
            "telephone_number": "203-874-0500",
            "fax_number": "203-874-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 STRATFORD AVE APT 319",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066156379",
            "telephone_number": "475-473-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JULIE",
        "name_prefix": "Miss",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2024-11-03",
        "certification_date": "2024-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "006162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucia Chou, M.D.
• Christina M Smillie, MD
• Deborah E Christy, LCSW
• Melissa Cicerchia
• Amy Cimminello, PA-C
• Novlette G Clarke, RN
• Clearsource Counseling, PLLC
• Clinicians Cove
• Coastal Connecticut Medical Group PLLC
• Coastal Natural Medicine, LLC

• All providers in Stratford, CT
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2024; 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.