Daryl Andrew Clarke, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

18090 Issued in MD

Practice address

12200 Annapolis Rd
Suite119
Glenn Dale, MD 20769-9182

Phone

(301) 805-5006

Fax

(301) 805-5004

NPI assigned

Feb 22, 2007

Last updated

Jun 20, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sports Pro Physical Therapy LLCGroup PAC ID 4688748106, 5 clinicians

Sports Pro Physical Therapy EastGroup PAC ID 1951770411, 2 clinicians

Sports Pro Physical Therapy South LLCGroup PAC ID 4880919638, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sports Pro Physical Therapy East

  • Physical Therapist
  • Annapolis, MD
  • NPI 1346998978
  Medicare reassignment Care Compare group NPD Authorized official
• Sports Pro Physical Therapy LLC

  • Physical Therapist
  • Upper Marlboro, MD
  • NPI 1285611608

  DC

  Medicare reassignment Care Compare group NPD Authorized official
• Sports Pro Physical Therapy South LLC

  • Physical Therapist
  • Fort Washington, MD
  • NPI 1124438700

  DC

  Medicare reassignment Care Compare group NPD Authorized official
• Sports Pro Physical Therapy LLC.

  • Physical Therapist
  • Glenn Dale, MD
  • NPI 1932576378
  NPD (past) Authorized official

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403222400000",
    "number": "1689709719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 ANNAPOLIS RD",
            "address_2": "SUITE119",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699182",
            "telephone_number": "301-805-5006",
            "fax_number": "301-805-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 ANNAPOLIS RD",
            "address_2": "SUITE119",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699182",
            "telephone_number": "301-805-5006",
            "fax_number": "301-805-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "DARYL",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2014-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "18090",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "2800",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3204256",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7910288",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST DC",
            "identifier": "H853 0001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI     OPT CHOICE",
            "identifier": "466223",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "686402-02",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sherri Crable, PT, DPT
• Denise C Crarey

• Physical Therapist in Glenn Dale, MD
• Providers in Glenn Dale, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; 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.