Erika Renea Clark

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA0000003342 Issued in TN

Practice address

12005 Teakwood CT
Bristol, VA 24202-3531

Phone

(276) 698-4305

NPI assigned

Oct 26, 2020

Last updated

Oct 26, 2020By 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

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1780284109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12005 TEAKWOOD CT",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242023531",
            "telephone_number": "276-698-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12005 TEAKWOOD CT",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242023531",
            "telephone_number": "276-698-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ERIKA",
        "middle_name": "RENEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TN",
            "license": "OTA0000003342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chin Lin Cheng, MD
• Jennifer Chisler, MS CCCSLP
• Amy Renae Chisom
• City of Bristol VA (Bristol Virginia Fire Department)
• Ashley Clark, COTA/L
• Nathan Andrew Clemson
• Hannah Cockerham
• Miranda Cole
• Tonya Renee Coleman, MS CCC SLP
• Stephanie Leann Collins, BC-HIS

• Occupational Therapy Assistant in Bristol, VA
• Providers in Bristol, VA by specialty
• Occupational Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.