Individual provider Active NPI

Sienna Marie Elizabeth Clark, DPT

  • Physical Therapist
  • Columbia, SC
National Provider Identifier
1962870022
Registry record updated Sep 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7912 Issued in SC
Practice address
141 Atrium Way
Columbia, SC 29223-6301
Phone
(803) 788-8484
NPI assigned
Sep 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7912 SC Primary

Addresses

Primary practice location

141 Atrium Way
Columbia, SC 29223-6301

Mailing address

2216 Rembert St
Columbia, SC 29201-1862
Phone (847) 997-6010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211014001216 FL Practitioner - Physical Therapist in Private Practice 7719288976 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7912SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Westchase Physical Therapy and Medical Supply LLC Physical Therapist CurrentSince Aug 2, 2021 Accepting new patients
Westchase Physical Therapy and Medical Supply LLC Physical Therapist CurrentSince Aug 2, 2021 Accepting new patients

Locations

12705 Race Track Rd
Westchase, FL 33626
Phone (813) 343-3960

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1441584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441584000000",
    "number": "1962870022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 REMBERT ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292011862",
            "telephone_number": "847-997-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 ATRIUM WAY",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236301",
            "telephone_number": "803-788-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SIENNA",
        "middle_name": "MARIE ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-07",
        "last_updated": "2015-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2015; 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.