Alicia Clark, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

12326251-4201 Issued in UT

Practice address

900 Round Valley Dr
Park City, UT 84060-7552

Phone

(435) 658-7000

NPI assigned

Nov 14, 2021

Last updated

Oct 5, 2022By the provider in NPPES

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

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.

• Bounce Therapy LLC

  • Physical Rehabilitation Occupational Therapist
  • Park City, UT
  • NPI 1255021424
  NPD Authorized official

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

{
    "created_epoch": "1636848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1790441798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6318 VIEW DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840986156",
            "telephone_number": "435-655-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 ROUND VALLEY DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607552",
            "telephone_number": "435-658-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ALICIA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-14",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "UT",
            "license": "12326251-4201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyrene L Christopulos, OT
• Jennifer A Chrystan, PH.D.
• Emil Chuang, MD
• Dylan Cirulis, DPT
• CJS1 Enterprises, Inc. (Mountain View Health and Wellness)
• Chad Jeremy Clark, D.O.
• Lauren Clark, MSN, APRN, FNP-C
• Terry K Clark, MD
• Katherine Clawson, DVM
• Clear Sky Speech Therapy, LLC

• Occupational Therapist in Park City, UT
• Providers in Park City, UT by specialty
• Occupational Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.