Alysia Marie Clark, DPT – Physical Therapist

Key facts

NPI: 1992933600
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapist 225100000X
License: 2787 (NE)
Practice address: 2222 N Lincoln Ave
York, NE 68467-1030
Phone: (402) 362-0436
Fax: (402) 362-0493
NPI assigned: Jul 1, 2009
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapist	225100000X	2787	NE	Yes

Addresses

Primary practice location

2222 N Lincoln Ave
York, NE 68467-1030

Mailing address

2222 N Lincoln Ave
York, NE 68467-1030
Phone (402) 362-0436

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 18, 2014.

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1992933600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 N LINCOLN AVE",
            "city": "YORK",
            "state": "NE",
            "postal_code": "684671030",
            "telephone_number": "402-362-0436",
            "fax_number": "402-362-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 N LINCOLN AVE",
            "city": "YORK",
            "state": "NE",
            "postal_code": "684671030",
            "telephone_number": "402-362-0436",
            "fax_number": "402-362-0493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ALYSIA",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-01",
        "last_updated": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, NE

All providers in York, NE · Physical Therapist in Nebraska

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2014. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.