Kelly Fisher Clark, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

NH1806 Issued in NH

Practice address

33 Morgan Dr
Lebanon, NH 03766-1408

Phone

(603) 643-7788

Fax

(603) 643-0022

NPI assigned

Nov 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Kelly Marie Fisher Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Cioffredi & Associates Physical Therapy, LLC

  • Physical Therapist
  • Lebanon, NH
  • NPI 1821298126

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322697600000",
    "number": "1760555809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 MORGAN DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661408",
            "telephone_number": "603-643-7788",
            "fax_number": "603-643-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 MORGAN DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661408",
            "telephone_number": "603-643-7788",
            "fax_number": "603-643-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KELLY",
        "middle_name": "FISHER",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2011-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NH",
            "license": "NH1806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30414483",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012138",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "FISHER",
            "middle_name": "MARIE",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cantwell Clark V, MD
• James Kenneth Seffinga Clark, M.D.
• Jean A. Clark, RN, MS, CCRN, APRN
• Jeffrey Allen Clark, M.D.
• Jenna Clark, MD
• Kristin D Clark, CRNA
• Sarah Ashley Clark
• Susannah Taylor Clark, M.D.
• Hannah Louise Cleary, DPT
• Patricia Quebada Clerkin, M.D.

• Occupational Therapist in Lebanon, NH
• Providers in Lebanon, NH by specialty
• Occupational Therapist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; 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.