Jennie Claire Clark

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4967 Issued in TN

Practice address

9216 Shawnee TRL
Brentwood, TN 37027-7415

Phone

(615) 221-8739

NPI assigned

May 5, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1730535006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306393",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306393",
            "telephone_number": "615-373-1350",
            "fax_number": "615-221-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9216 SHAWNEE TRL",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277415",
            "telephone_number": "615-221-8739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 International Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "TN",
            "postal_code": "370671762",
            "country_code": "US",
            "telephone_number": "615-224-9818",
            "fax_number": "615-224-9862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JENNIE",
        "middle_name": "CLAIRE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-05",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TN",
            "license": "0496",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "4967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Clapp
• Clark & Sanchez Health Center LLC
• Ashley Nutt Clark, NP
• Carol Shelby Clark, OT
• Christian Clark
• Jesse Clark, CNIM
• Jessie F Clark
• Riley Clark, MS, CCC-SLP
• Robert Cornelius Clark III, PHARMD
• Sara Ansley Clark

• Physical Therapist in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.