Active NPI
Leeann Clark, PT
- Physical Therapist
- Wyndmoor, PA
National Provider Identifier
1861517443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT004075L
- Practice address
- 8765 Stenton Avenue
Wyndmoor, PA 19038-8317 - Phone
- (215) 836-2440
- Fax
- (215) 836-2448
- NPI assigned
- Mar 20, 2007
- 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 Therapist | 225100000X | PT004075L | PA | Primary |
Addresses
Primary practice location
8765 Stenton Avenue
Wyndmoor, PA 19038-8317
Mailing address
8765 Stenton Avenue
Wyndmoor, PA 19038-8317
Phone (215) 836-2440
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 |
|---|---|---|---|
| PT004075L | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743379200000",
"number": "1861517443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8765 STENTON AVENUE",
"city": "WYNDMOOR",
"state": "PA",
"postal_code": "190388317",
"telephone_number": "215-836-2440",
"fax_number": "215-836-2448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8765 STENTON AVENUE",
"city": "WYNDMOOR",
"state": "PA",
"postal_code": "190388317",
"telephone_number": "215-836-2440",
"fax_number": "215-836-2448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "LEEANN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2025-03-31",
"certification_date": "2025-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT004075L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyndmoor, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.