Active NPI
Jude Joseph Clark II, P.T.
- Physical Therapist
- Kenner, LA
National Provider Identifier
1831228501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 01390
- Practice address
- 4416 Rue de la HBR
Kenner, LA 70065-1143 - Phone
- (504) 220-4380
- NPI assigned
- Mar 5, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 01390 | LA | Primary |
Addresses
Primary practice location
4416 Rue de la HBR
Kenner, LA 70065-1143
Mailing address
4416 Rue de la HBR
Kenner, LA 70065-1143
Phone (504) 220-4380
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 |
|---|---|---|---|
| 01390 | LA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831228501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4416 RUE DE LA HBR",
"city": "KENNER",
"state": "LA",
"postal_code": "700651143",
"telephone_number": "504-220-4380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4416 RUE DE LA HBR",
"city": "KENNER",
"state": "LA",
"postal_code": "700651143",
"telephone_number": "504-220-4380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JUDE",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"name_suffix": "II",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "01390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenner, LA
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.