Active NPI
Andrea K Clark
- Occupational Therapist
- Hickman, NE
National Provider Identifier
1982182309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2227
- Practice address
- 920 Goldenrod LN
Hickman, NE 68372-9509 - Phone
- (402) 560-3651
- NPI assigned
- Jul 30, 2018
- Last updated
- Jun 9, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2227 | NE | Primary |
Addresses
Primary practice location
920 Goldenrod LN
Hickman, NE 68372-9509
Mailing address
20318 180TH St
Rockwell, IA 50469-8680
Phone (402) 560-3651
Other practice location 1
11623 Arbor St Apt 201
Omaha, NE 68144-2981
Phone (402) 334-6088
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Clark.Andrea@direct.2mycarefile.org | Direct | MercyOne North Iowa |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2227 | NE | MD | Chiropractor |
Interoperability endpoints
- clark.andrea@direct.2mycarefile.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623196800000",
"number": "1982182309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20318 180TH ST",
"city": "ROCKWELL",
"state": "IA",
"postal_code": "504698680",
"telephone_number": "402-560-3651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 GOLDENROD LN",
"city": "HICKMAN",
"state": "NE",
"postal_code": "683729509",
"telephone_number": "402-560-3651"
}
],
"practiceLocations": [
{
"address_1": "11623 Arbor St Apt 201",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "681442981",
"country_code": "US",
"telephone_number": "402-334-6088",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLARK",
"first_name": "ANDREA",
"middle_name": "K",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-30",
"last_updated": "2021-06-09",
"certification_date": "2021-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "2227",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Clark.Andrea@direct.2mycarefile.org",
"affiliation": "Y",
"endpointDescription": "Direct Email Address",
"affiliationName": "MercyOne North Iowa",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "1000 4th St SW",
"city": "Mason City",
"state": "IA",
"country_code": "US",
"postal_code": "504012800",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Hickman, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.