MR. CHARLES KEVIN CLARK (NPI# 1093722902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093722902 |
| Entity Type | Individual |
| Full Name | MR. CHARLES KEVIN CLARK |
| Credential | P.T. |
| Practice Address |
10214 N Tatum Blvd Suite B-500 Phoenix AZ 85028-4224 |
| Mailing Address |
10214 N Tatum Blvd Ste B500 Phoenix AZ 85028-4224 |
| Practice Telephone | 4802646326 |
| Practice Fax Number | 4802646328 |
| Mailing Telephone | 4802365360 |
| Mailing Fax Number | 4809910139 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2019-09-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | 5471 | AZ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760940753 | Charles Patrick Clark | Physician Assistant | 6621 Fannin St, Houston, Houston, TX 77030 | 2019-03-08 |
| 1013485713 | Charles Nicholson Clark | Nurse Practitioner | 1331 Bandera Hwy Ste 4, Kerrville, TX 78028-9535 | 2018-11-12 |
| 1568971653 | Charles E Clark IIi | Counselor | 255 Main Street, St. Clairsville, OH 43950 | 2017-09-21 |
| 1649680406 | Charles Amos Clark | Internal Medicine | Vanderbilt University Dept of Medicine, D-3100, Medical Center North, Nashville, TN 37232 | 2014-05-02 |
| 1124301106 | Charles Malcolm Clark Jr. | Internal Medicine | 2802 Lafayette Road Suite 13, Eagledale Health Center, Indianapolis, IN 46222-2112 | 2011-09-26 |
| 1811290935 | Charles Warren Clark Jr. | Massage Therapist | 19577 Fm 2854 Rd, Montgomery, TX 77316-3150 | 2010-12-11 |
| 1780913640 | Charles S Clark | Physician Assistant | Bldg. H 2005 Knight Lane Attn: Medical Staff Services, Navy Medicine Support Command, Jacksonville, FL 92055-0140 | 2009-12-23 |
| 1083866222 | Charles Larry Clark Jr. | Dentist | 2415 Gillionville Rd, Albany, GA 31707-3022 | 2008-10-21 |
| 1689826984 | Charles John Clark | Pharmacist | 203 So. Daisy, Salmon, ID 83467 | 2008-10-17 |
| 1164642948 | Charles Robert Clark | Family Medicine | 1725 N Sky Glen Path, Hernando, FL 34442-6187 | 2007-04-26 |
| Street Address |
10214 N TATUM BLVD SUITE B-500 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85028-4224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194116475 | Hiem Dental | Dentist | 10214 N Tatum Blvd, B600, Phoenix, AZ 85028-4231 | 2015-02-09 |
| 1922255744 | Varsity Physical Therapy, L.L.C. | Physical Therapist | 10214 N Tatum Blvd, Phoenix, AZ 85028-5216 | 2008-08-22 |
| 1992713952 | David Henry Boca | Dentist | 10214 N Tatum Blvd, A600, Phoenix, AZ 85028 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235626565 | Celice Korsten | Psychologist | 11020 N. Tatum Blvd., Ste. 100, Phoenix, AZ 85028 | 2018-04-23 |
| 1720591605 | Michele Kaplan | Counselor | 11640 N Tatum Blvd #3096, Phoenix, AZ 85028 | 2017-11-14 |
| 1154840304 | Faustino M. Gonzalez, Md PC | Anesthesiology | 11811 N. Tatum Blvd, Suite 3031, Phoenix, AZ 85028 | 2017-09-19 |
| 1679092514 | Savior Palliative Care LLC | Family Medicine | 4530 E Shea Blvd Ste 175, Phoenix, AZ 85028 | 2017-09-12 |
| 1437688892 | Harmony Behavioral Health | Behavioral Analyst | 3008 E Sierra St, Phoenix, AZ 85028 | 2017-06-08 |
| 1275949224 | Alexander D Garza | Podiatrist | 3101 E Shea Blvd Ste 220, Phoenix, AZ 85028 | 2014-07-09 |
| 1720418379 | Alyssa Hale | Occupational Therapy Assistant | 4600 East Shea Boulevard, Suite 101, Phoenix, AZ 85028 | 2013-11-19 |
| 1932534476 | Stephen Howard Garber | Otolaryngology | 9607 N. 43rd Way, Phoenix, AZ 85028 | 2013-09-03 |
| 1366798050 | Irna Lynn Shamos | Clinical Neuropsychologist | 4516 East Onyx Avenue, Arizona Psychological Diagnostics, Plc, Phoenix, AZ 85028 | 2012-07-31 |
| 1285930925 | Cathy Ann Payne | Nurse Practitioner | 11209 N Tatum Blvd Ste 260, Phoenix, AZ 85028 | 2011-01-27 |
| Find all providers in zip 85028 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093321895 | Launch Physical Therapy & Performance Center, LLC | Physical Therapist | 1500 E Thomas Rd Unit 110, Phoenix, AZ 85014-5708 | 2020-09-17 |
| 1881205417 | Diligence Physical Therapy and Wellness, Pllc | Physical Therapist | 3101 N. Central Avenue, Suite 183 # 518, Phoenix, AZ 85012 | 2020-08-17 |
| 1255943874 | Clarke B Antonio | Physical Therapist | 11225 N 28th Dr # Srf100, Phoenix, AZ 85029-5606 | 2020-08-17 |
| 1174133805 | Samuel Curtis | Physical Therapist | 4050 E Cotton Center Blvd Ste 18, Phoenix, AZ 85040-8862 | 2020-08-06 |
| 1548878572 | Rachel Lynn Wood | Physical Therapist | 1860 N 95th Ln Ste 105, Phoenix, AZ 85037-4333 | 2020-07-15 |
| 1821615303 | Nicholas Johnston | Physical Therapist | 4550 N Black Canyon Hwy, Phoenix, AZ 85017-3714 | 2020-06-30 |
| 1568088979 | Alexandra Ashby | Physical Therapist | 2229 N 17th Ave, Phoenix, AZ 85007-1403 | 2020-06-22 |
| 1508490301 | Lisa Ann Viscuso | Physical Therapist | 13 Cooperstown Ct, Phoenix, MD 21131-1328 | 2020-03-02 |
| 1487287496 | Ulrich Ernst Grigo | Physical Therapist | 14431 S 43rd Pl, Phoenix, AZ 85044-6127 | 2020-02-18 |
| 1750914941 | Kevin D Allen | Physical Therapist | 2005 W Happy Valley Rd Ste 170, Phoenix, AZ 85085-2898 | 2020-02-17 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.