Heidi Clark, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501016656 Issued in MI

Practice address

2455 Union Lake Rd
Commerce TWP, MI 48382-3596

Phone

(248) 363-1234

Fax

(248) 353-1211

NPI assigned

Apr 15, 2014

Last updated

Apr 15, 2014By 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

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.

• Auto & Work Comp Rehab LLC

  • Physical Therapy Clinic/Center
  • Southfield, MI
  • NPI 1750618898
  NPD (past)

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1962821041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29255 NORTHWESTERN HWY",
            "address_2": "SUITE 300",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341018",
            "telephone_number": "248-353-1234",
            "fax_number": "248-353-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 UNION LAKE RD",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "483823596",
            "telephone_number": "248-363-1234",
            "fax_number": "248-353-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "HEIDI",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Cantor, M.D.
• Care With Compassion Physician Group PC
• Shannon Carlson, CRNA
• Jung Hoon Chang, MD
• Charter Township of Commerce
• Jamie Lynn Clark, CRNA
• Cathy Clubb, M.D.
• Colleen Bertani PC
• Endia Collins
• Commerce Internal Medicine, P.C.

• Physical Therapist in Commerce TWP, MI
• Providers in Commerce TWP, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.