Active NPI
Elizabeth Ann Clark, ATC
- Athletic Trainer
- Bernville, PA
National Provider Identifier
1801938774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- RT003812
- Practice address
- 430 New Schaefferstown Rd
Bernville, PA 19506-8939 - Phone
- (610) 763-3337
- NPI assigned
- Feb 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | RT003812 | PA | Primary |
Addresses
Primary practice location
430 New Schaefferstown Rd
Bernville, PA 19506-8939
Mailing address
1100 E Wyomissing Blvd
Apt 34-C
Reading, PA 19611-2142
Phone (610) 763-3337
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RT003812 | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801938774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 E WYOMISSING BLVD",
"address_2": "APT 34-C",
"city": "READING",
"state": "PA",
"postal_code": "196112142",
"telephone_number": "610-763-3337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 NEW SCHAEFFERSTOWN RD",
"city": "BERNVILLE",
"state": "PA",
"postal_code": "195068939",
"telephone_number": "610-763-3337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "ELIZABETH",
"middle_name": "ANN",
"name_prefix": "Miss",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT003812",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bernville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.