Active NPI
Kerry Leann Clark
- Physical Therapy Assistant
- Chetopa, KS
National Provider Identifier
1851607162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 14-01713
- Practice address
- 814 Walnut St
Chetopa, KS 67336-8990 - Phone
- (620) 236-7248
- NPI assigned
- Aug 24, 2010
- Last updated
- Aug 24, 2010
- Sex
- Female
- Sole proprietor
- No
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 Therapy Assistant | 225200000X | 14-01713 | KS | Primary |
Addresses
Primary practice location
814 Walnut St
Chetopa, KS 67336-8990
Mailing address
1217 S 15TH St
Parsons, KS 67357-5125
Phone (620) 421-2431
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 |
|---|---|---|---|
| 14-01713 | KS | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282608000000",
"number": "1851607162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1217 S 15TH ST",
"city": "PARSONS",
"state": "KS",
"postal_code": "673575125",
"telephone_number": "620-421-2431",
"fax_number": "620-423-0158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "814 WALNUT ST",
"city": "CHETOPA",
"state": "KS",
"postal_code": "673368990",
"telephone_number": "620-236-7248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "KERRY",
"middle_name": "LEANN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-24",
"last_updated": "2010-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "KS",
"license": "14-01713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chetopa, KS
- Cynthia Ann Brady, PTA
- Cah Acquisition Company 2 LLC (Chetopa Community Clinic)
- David Wayne Carter, PHARMD, RPH, PD
- Chetopa-St. Paul Usd505
- Haskell Regional Hospital, Inc. (ONH Medical Group, Chetopa)
- Labette County Medical Center (Labette Health Chetopa Clinic)
- Riggs Drugs Inc (Riggs Drugs Store)
- Riggs Drugs Inc
- Kori Kay Ross, MS SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.