Sally O Clancy, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT3472 Issued in MS

Practice address

2205 Jefferson Davis Dr
Oxford, MS 38655-5221

Phone

(662) 238-2800

Fax

(662) 238-2808

NPI assigned

Jun 30, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Cornerstone Rehabilitation of Oxford, Inc

  • Physical Therapist
  • Oxford, MS
  • NPI 1538104153
  NPD (past)
• Endurance Physical Therapy

  • Physical Therapist
  • Oxford, MS
  • NPI 1124538863
  NPD (past)

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257897600000",
    "number": "1689603904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1016",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555221",
            "telephone_number": "662-238-2800",
            "fax_number": "662-238-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 JEFFERSON DAVIS DR",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555221",
            "telephone_number": "662-238-2800",
            "fax_number": "662-238-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANCY",
        "first_name": "SALLY",
        "middle_name": "O",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2009-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT3472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00126119",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chris a. Varva, DPM, PLLC
• Karen Christoff, PH.D.
• April Forshay Christon, MSCE
• Christopher Marascalco Cummins MD LLC
• Dixie J Church, MA
• Charlsea Dee Clark-Stowe, M.S.
• Casey J. Clark, P.T.
• Clayton Clark, PHARMD
• Emma Clark, FNP-C
• Heather Lynn Clark, M.S.

• Physical Therapist in Oxford, MS
• Providers in Oxford, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; 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.