Active NPI
Stacie Clark, MPT
- Physical Therapist
- Stoneboro, PA
National Provider Identifier
1770599292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT06825
- Practice address
- 2447 Mercer St
Stoneboro, PA 16153-2711 - Phone
- (724) 376-3666
- Fax
- (724) 376-2460
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT06825 | PA | Primary |
Addresses
Primary practice location
2447 Mercer St
Stoneboro, PA 16153-2711
Mailing address
3449 Hadley Rd
Hadley, PA 16130-2821
Phone (724) 253-1044
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT06825 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297987200000",
"number": "1770599292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3449 HADLEY RD",
"city": "HADLEY",
"state": "PA",
"postal_code": "161302821",
"telephone_number": "724-253-1044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2447 MERCER ST",
"city": "STONEBORO",
"state": "PA",
"postal_code": "161532711",
"telephone_number": "724-376-3666",
"fax_number": "724-376-2460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "STACIE",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2011-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT06825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stoneboro, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.