Individual provider Active NPI

Kylie Clark, DPT

  • Physical Therapist
  • Louisville, KY
National Provider Identifier
1871478057
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
009361 Issued in KY
Practice address
805 Blankenbaker Pkwy Ste 107
Louisville, KY 40243-2804
Phone
(502) 253-0833
NPI assigned
Aug 7, 2025
Last updated
Aug 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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 009361 KY Primary

Addresses

Primary practice location

805 Blankenbaker Pkwy Ste 107
Louisville, KY 40243-2804

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250908003274 KY Practitioner - Physical Therapist in Private Practice 7911409966 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Practice addresses (Care Compare)

805 Blankenbaker Pkwy
Suite 107
Louisville, KY 40243-2804
Phone (502) 253-0833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Kentucky LLC Physical Therapist CurrentSince Aug 6, 2025 Accepting new patients
Benchmark Physical Therapy of Ky LLC Physical Therapist CurrentSince Aug 6, 2025 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Aug 6, 2025 Accepting new patients
Drayer Physical Therapy Kentucky LLC Physical Therapist CurrentSince Aug 6, 2025 Accepting new patients
Results-Ast JV, LLC Physical Therapist CurrentSince Aug 6, 2025 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Aug 6, 2025 Accepting new patients
Agilitas USA Inc Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1725 Scottsville Rd
Bowling Green, KY 42104
Phone (270) 467-9969

861 Fairview Ave
Ste 102
Bowling Green, KY 42101
Phone (270) 783-8438

1588 Leestown Rd
Ste 120
Lexington, KY 40511
Phone (859) 317-8086

1917 Blankenbaker Pkwy
Louisville, KY 40299
Phone (502) 409-8094

805 Blankenbaker Pkwy
Louisville, KY 40243
Phone (502) 253-0833

805 Blankenbaker Pkwy
Ste 107
Louisville, KY 40243
Phone (502) 253-0833

200 Codella Dr
Ste B
Winchester, KY 40391
Phone (859) 745-2152

Organizations & group practices 8

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": "1754524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1871478057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 BLANKENBAKER PKWY STE 107",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402432804",
            "telephone_number": "502-253-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KYLIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-07",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "009361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.