Kenyetta Clarke

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5202007550 Issued in MI

Practice address

8481 Holly Rd
Grand Blanc, MI 48439-1812

Phone

(810) 694-6382

NPI assigned

Nov 14, 2013

Last updated

Nov 14, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• K&J Loving Hands

  • In Home Supportive Care Agency
  • Flint, MI
  • NPI 1881417582
  NPD Authorized official

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

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384387200000",
    "number": "1740610559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8481 HOLLY RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "48439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8481 HOLLY RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391812",
            "telephone_number": "810-694-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "KENYETTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-14",
        "last_updated": "2013-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MI",
            "license": "5202007550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Chute, P.A.
• Joelle Ann Cirella-Grandy, OTR/L
• Shane T. Citron, D.D.S., M.D.
• Michelle Marie Clark, LMSW
• Toni Clark, M.ED, BCBA, LBA
• Valeria Dionne Clarke
• Camara D Clements
• CMR Ultrasound, LLC.
• Cognosis Health
• Cognosis Health

• Occupational Therapy Assistant in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Occupational Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2013; 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.