Ashley Nicole Clark, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5901 Issued in OK

Practice address

12755 S Mur Len Rd Ste B1
Olathe, KS 66062-6804

Phone

(913) 782-8729

Fax

(913) 782-7209

NPI assigned

Jul 8, 2019

Last updated

May 21, 2021By 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 3

Addresses

Other names 1

• Ashley Nicole Pennington Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Elevate Pelvic Health & Wellness

  • Physical Therapy Clinic/Center
  • Overland Park, KS
  • NPI 1568321545
  NPD Authorized official
• Elevate Physical Therapy

  • Physical Medicine & Rehabilitation Physician
  • Edmond, OK
  • NPI 1932834223
  NPD Authorized official

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1902468200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214915",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12755 S MUR LEN RD STE B1",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660626804",
            "telephone_number": "913-782-8729",
            "fax_number": "913-782-7209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2475 Boardwalk",
            "address_purpose": "LOCATION",
            "city": "Norman",
            "state": "OK",
            "postal_code": "730696332",
            "country_code": "US",
            "telephone_number": "405-447-1991",
            "fax_number": "405-447-1998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "3984",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-06159",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "PENNINGTON",
            "middle_name": "NICOLE",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hanna Churchill
• Guillermo Enrique Cintron, LMSW
• Sharon Clair, R.N.
• Clarity Dermatology and Skin Cancer Center LLC
• Clarity Health KC, LLC
• Catherine Sue Clark, LSCSW
• Eva Clark, WHNP
• Maureen Sherdan Clark
• Stephen D Clark, MD
• Fred Wallace Clarke, D.C.

• Physical Therapist in Olathe, KS
• Providers in Olathe, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.