Active NPI
Jennifer Sara Clark, PT
- Physical Therapist
- West Hempstead, NY
National Provider Identifier
1851707194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 036614-1
- Practice address
- 797 Evergreen Dr
West Hempstead, NY 11552-3406 - Phone
- (516) 286-4654
- NPI assigned
- Jul 8, 2014
- Sex
- Female
- 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 | 036614-1 | NY | Primary |
Addresses
Primary practice location
797 Evergreen Dr
West Hempstead, NY 11552-3406
Mailing address
797 Evergreen Dr
West Hempstead, NY 11552-3406
Phone (516) 286-4654
Other names 1
- Jennifer Sara Siegel
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036614-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519948800000",
"number": "1851707194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "797 EVERGREEN DR",
"city": "WEST HEMPSTEAD",
"state": "NY",
"postal_code": "115523406",
"telephone_number": "516-286-4654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "797 EVERGREEN DR",
"city": "WEST HEMPSTEAD",
"state": "NY",
"postal_code": "115523406",
"telephone_number": "516-286-4654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JENNIFER",
"middle_name": "SARA",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-08",
"last_updated": "2018-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "036614-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "SIEGEL",
"middle_name": "SARA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in West Hempstead, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.