Alexa Clark, OTD

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

2022012872 Issued in MO

Practice address

1807 W Broadway Blvd
Sedalia, MO 65301-2566

Phone

(660) 826-2015

NPI assigned

Jun 10, 2019

Last updated

Oct 26, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Select Physical Therapy Holdings Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Cape Girardeau, MO
  • NPI 1316907884
  NPD (past)

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1831758234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 CARVED TER",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809191129",
            "telephone_number": "719-287-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 W BROADWAY BLVD",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012566",
            "telephone_number": "660-826-2015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6985 Tutt Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809233588",
            "country_code": "US",
            "telephone_number": "719-332-4689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ALEXA",
        "credential": "OTD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "0005993",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "MO",
            "license": "2022012872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dalton Christian
• Kelsey Christian
• Logan Chronister, FNP-BC
• Diane Elizabeth Ciafullo, L.C.S.W.
• Tammy Kaye Claerhout, LMSW
• Clearsound Hearing LLC
• Robert M Clemens, MD
• Clinical Radiological Consultants Inc
• Leslie Cochren, COTA
• Samuel Jon Cole

• Hand Occupational Therapist in Sedalia, MO
• Providers in Sedalia, MO by specialty
• Hand Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.