Elizabeth Clark, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

28857 Issued in MD

Practice address

1306 Military Rd Ste 1
Benton, AR 72015-2732

Phone

(501) 481-8930

NPI assigned

Feb 19, 2018

Last updated

Oct 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Maryland Luna Care Physical Therapy LLC

  • Physical Therapist
  • Chevy Chase, MD
  • NPI 1083340988

  DC

  Medicare reassignment NPD
• Arkansas Therapy Outreach, LLC

  • Developmental Disabilities Clinic/Center
  • Benton, AR
  • NPI 1568986248
  NPD (past)
• Behavior Bridges ABA LLC

  • Behavior Analyst
  • Bryant, AR
  • NPI 1265314645
  NPD (past)
• J5 Therapy, Inc.

  dba Behavior Bridges ABA LLC

  • Behavior Analyst
  • Bryant, AR
  • NPI 1427867050
  NPD (past)

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1922508613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N BUCHANAN ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053208",
            "telephone_number": "724-355-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 MILITARY RD STE 1",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152732",
            "telephone_number": "501-481-8930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 N Prickett Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Bryant",
            "state": "AR",
            "postal_code": "720227511",
            "country_code": "US",
            "telephone_number": "501-213-0594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ELIZABETH",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-19",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "28857",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT027442",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT4428",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Treva M Churchwell, RN WON
• Cindy J. Webb, PLLC
• Blakely Cingolani
• Civitan Center (Civitan Services)
• Courtney A Clark, LPC
• Thomas Clark, QBHP
• Alexis Landers Clement
• Cliff Hays DDS PA
• Auriel Clincy, QBHP
• Tanisha Clinkscale, RECOVERY ASSISTANT

• Physical Therapist in Benton, AR
• Providers in Benton, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.