Breon Clark

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT40539 Issued in FL

Practice address

507 S Orange St
New Smyrna Beach, FL 32168-7318

Phone

(386) 424-5181

NPI assigned

Jan 8, 2026

Sex

Male

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 and National Provider Directory roles.

• Southeast Volusia Healthcare Corporation

  • Internal Medicine Physician
  • New Smyrna Beach, FL
  • NPI 1710346093
  NPD (past)

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

{
    "created_epoch": "1767830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1821955154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 S ORANGE ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687318",
            "telephone_number": "386-424-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 S ORANGE ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687318",
            "telephone_number": "386-424-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BREON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-08",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT40539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine B. Bailey, PH.D., PC
• Christopher Chien D. Mai, MD,PA
• Clifford C. Chu, M.D.
• Church Parish Nurse Ministries
• Georgia Clanton
• Cadence Clark
• Kaitlyn Clark, PT, DPT
• Sonya Miciak Clark, D.O.
• Tina Michelle Claybourn, LMT
• Lara L Clevenger, RD

• Physical Therapist in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; 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.