Individual provider Active NPI

Harold Bart Clark, OTR

  • Occupational Therapist
  • Grandview, TX
National Provider Identifier
1750404950
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
106141 Issued in TX
Practice address
103 N 3Rd St
Grandview, TX 76050-1915
Phone
(817) 866-2779
Fax
(817) 866-4367
NPI assigned
Apr 10, 2007
Last updated
Nov 23, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 106141 TX Primary

Addresses

Primary practice location

103 N 3Rd St
Grandview, TX 76050-1915

Mailing address

103 N 3Rd St
Grandview, TX 76050-1915
Phone (817) 866-2779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106141TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tolkien Lewis & Clark, Inc Occupational Therapist PastSince Dec 15, 2009 Accepting new patients
Davidson Physical Therapy PC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1750404950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 N 3RD ST",
            "city": "GRANDVIEW",
            "state": "TX",
            "postal_code": "760501915",
            "telephone_number": "817-866-2779",
            "fax_number": "817-866-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N 3RD ST",
            "city": "GRANDVIEW",
            "state": "TX",
            "postal_code": "760501915",
            "telephone_number": "817-866-2779",
            "fax_number": "817-866-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "HAROLD",
        "middle_name": "BART",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "106141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.