Samantha Jo Clark, MS, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

026782 Issued in NY

Practice address

344 Menemsha LN
Troy, NY 12180-7276

Phone

(518) 283-5752

NPI assigned

Nov 20, 2023

Last updated

Nov 20, 2023By 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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1811762859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NEW BROADWAY APT 421",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121442159",
            "telephone_number": "916-517-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 MENEMSHA LN",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121807276",
            "telephone_number": "518-283-5752"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Van Rensselaer Dr",
            "address_purpose": "LOCATION",
            "city": "Rensselaer",
            "state": "NY",
            "postal_code": "121441491",
            "country_code": "US",
            "telephone_number": "518-396-3520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "026782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Marie Cioffi, LPN
• Christina Marie Cipperley, M.S, CCC-SLP
• Cindy Cirillo, OPTICIAN
• City of Troy
• Joy Ann Clark, O.T.R.
• Tracy Jill Clark
• Nancy J Clarke, MA, PT
• Jessica Sam Clayton
• Brian Clemente
• Matthew J Clemente, DDS

• Occupational Therapist in Troy, NY
• Providers in Troy, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.