Cheryl Clark, PTA A4176

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A4176 Issued in MD

Practice address

5721 Grosvenor LN
Bethesda, MD 20814-1833

Phone

(301) 530-1600

NPI assigned

Feb 18, 2019

Last updated

Feb 18, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1550448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1881150613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LAUER TER # 5",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209014926",
            "telephone_number": "301-587-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5721 GROSVENOR LN",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208141833",
            "telephone_number": "301-530-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHERYL",
        "credential": "PTA   A4176",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-18",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A4176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A4176",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CJ's Transport
• Ashley Claiborne, LCSW-C
• Alexis Lauren Clapper
• Clarity Brain and Body Clinic LLC
• Barbara B Clark, CRNP
• Cyerra Yvette Clark
• Katharine Tyler Clark, MD
• Katherine Mairi Clark, MD
• Nancy Claire Clark, M.D.
• Paul Albert Clark, D.O.

• Physical Therapy Assistant in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Physical Therapy Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.