Lindsey Alice Clark, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2559-19 Issued in WI

Practice address

2140 Duluth PL
Maplewood, MN 55109-3414

Phone

(612) 807-0851

NPI assigned

Oct 3, 2016

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

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": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1891244794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 DULUTH PL",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551093414",
            "telephone_number": "612-807-0851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 DULUTH PL",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551093414",
            "telephone_number": "612-807-0851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LINDSEY",
        "middle_name": "ALICE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2559-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Knecht Church, PH.D. LP
• Margaret Phelps Chute, MD
• Johnathan Cicchese, DPT
• City of Maplewood
• Carol Jones Clark, MS CCC SLP
• Mary Martha Clark, OTR-L
• Sean Hoban Clark
• Clayton D. Sankey Licsw, LLC
• Cochran Recovery Services
• Emily M Coffman, DPT

• Physical Therapy Assistant in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Physical Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; 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.