Walter K. Cleary, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

966 Issued in KY

Practice address

1480 18TH St
Corbin, KY 40701-2721

Phone

(606) 528-0870

Fax

(606) 528-3449

NPI assigned

Jun 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Revolution Physical Therapy Corbin

  • Physical Therapist
  • Corbin, KY
  • NPI 1861231524
  NPD (past)

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201564800000",
    "number": "1841294899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 18TH ST",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012721",
            "telephone_number": "606-528-0891",
            "fax_number": "606-528-3449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 18TH ST",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012721",
            "telephone_number": "606-528-0870",
            "fax_number": "606-528-3449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEARY",
        "first_name": "WALTER",
        "middle_name": "K.",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2008-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "1263",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "640224",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "00000004875",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frank C Clark, MD
• Lisa F Clark, LPCC
• Mary Leann Clark, M.S., CCC-SLP
• Stacey Clark, TCADC
• Samantha Clawson, PHARMD
• Rebecca Belle Clemons, MA, LCADC
• Keith A. Clifton, M.D.
• Laura Clifton, PA-C
• Cloud Medical Supply
• Adrian Cloud

• Physical Therapist in Corbin, KY
• Providers in Corbin, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; 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.