Individual provider Active NPI

Emily Hardy Clark, DPT

  • Physical Therapist
  • Hermon, ME
National Provider Identifier
1861947442
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT4653 Issued in ME
Practice address
2263 Route 2
Hermon, ME 04401-0605
Phone
(207) 848-9009
Fax
(207) 404-2562
NPI assigned
Aug 24, 2016
Last updated
Aug 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT4653 ME Primary

Addresses

Primary practice location

2263 Route 2
Hermon, ME 04401-0605

Mailing address

2263 Route 2
Hermon, ME 04401-0605
Phone (207) 848-9009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160923001568 ME Practitioner - Physical Therapist in Private Practice 5890082515 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT4653MEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Covey Physical Therapy Physical Therapist CurrentSince Sep 1, 2021 Accepting new patients
Bridgton Hospital CurrentSince Mar 1, 2020 Accepting new patients
Rumford Hospital CurrentSince Mar 1, 2020 Accepting new patients
Central Maine Clinical Associates Corporation Current Accepting new patients
Bridgton Hospital CurrentSince Mar 1, 2020 Accepting new patients
Central Maine Clinical Associates CurrentSince Aug 22, 2016 Accepting new patients
Central Maine Clinical Associates CurrentSince Aug 22, 2016 Accepting new patients
Rumford Hospital CurrentSince Mar 1, 2020 Accepting new patients
Rumford Community Family Health Center, Inc. Past Accepting new patients

Locations

10 Hospital Dr
Bridgton, ME 04009
Phone (207) 647-6000

2263 Route 2
Hermon, ME 04401
Phone (207) 848-9009

29 Lowell St
Lewiston, ME 04240
Phone (207) 795-2154

364 Main St
Lewiston, ME 04240
Phone (207) 795-5646

420 Franklin St
Rumford, ME 04276
Phone (207) 364-4581

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1861947442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2263 ROUTE 2",
            "city": "HERMON",
            "state": "ME",
            "postal_code": "044010605",
            "telephone_number": "207-848-9009",
            "fax_number": "207-404-2562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2263 ROUTE 2",
            "city": "HERMON",
            "state": "ME",
            "postal_code": "044010605",
            "telephone_number": "207-848-9009",
            "fax_number": "207-404-2562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "EMILY",
        "middle_name": "HARDY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-24",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT4653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermon, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.