Individual provider Active NPI

Robert William Clark Jr., MPT

  • Physical Therapist
  • Brownsville, PA
National Provider Identifier
1710966106
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT010856L Issued in PA
Practice address
113 Thornton Rd
Suite D
Brownsville, PA 15417-9607
Phone
(724) 785-2853
NPI assigned
Jan 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT010856L PA Primary

Addresses

Primary practice location

113 Thornton Rd
Suite D
Brownsville, PA 15417-9607

Mailing address

211 Easy St
Suite 211
Uniontown, PA 15401-3129
Phone (724) 437-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230807003881 NC Practitioner - Physical Therapist in Private Practice 8628049947 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regent LLCGroup PAC ID 5698098630, 6 clinicians

Practice addresses (Care Compare)

906 Burch Ave
Durham, NC 27701-2816
Phone (336) 662-3737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT010856LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Solana Rehab LLC CurrentSince Oct 1, 2023 Accepting new patients
Regent LLC CurrentSince Jun 15, 2023 Accepting new patients
Redstone Rehabilitation Group Inc PastSince Mar 13, 1998 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1710966106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 EASY ST",
            "address_2": "SUITE 211",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154013129",
            "telephone_number": "724-437-8200",
            "fax_number": "724-437-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 THORNTON RD",
            "address_2": "SUITE D",
            "city": "BROWNSVILLE",
            "state": "PA",
            "postal_code": "154179607",
            "telephone_number": "724-785-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ROBERT",
        "middle_name": "WILLIAM",
        "name_suffix": "Jr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT010856L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.