Benjamin Clark (NPI# 1285189704, PAC ID# 0143571141) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1285189704 |
| PAC ID by PECOS | 0143571141 |
| Professional Enrollment ID | I20181001000793 |
| Full Name | Benjamin Clark |
| Organization Legal Name | CAROLINA REHABILITATION INC |
| Address |
20 Medical Campus Dr Suite 204 Supply NC 28462-0001 |
| Phone Number | 9107555861 |
| Gender | M |
| Graduation Year | 2016 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 8628018843 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 159 Crossover Rd, Beulaville, NC 28518-8801 | 9102986455 | CAROLINA REHABILITATION INC |
| 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 | 9107555861 | CAROLINA REHABILITATION INC |
| Organization Legal Name | CAROLINA REHABILITATION INC |
| Physicians | 15 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nikolos W Boehmer | Physical Therapy | Carolina Rehabilitation Inc | 4979 Southport Supply Rd, Southport, NC 28461-8742 |
| Amanda Rae Gillilan | Physical Medicine and Rehabilitation | Carolina Rehabilitation Inc | 1722 A N Kerr Ave, Wilmington, NC 28405-1038 |
| Rita M Desimone | Occupational Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Mary F Stoker | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Thomas Lair | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Kurt Kildow | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Scott Thomas | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Brittainy R Edwards Kidlow | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| John Michael Elson | Physical Medicine and Rehabilitation | Carolina Rehabilitation Inc | 4979 Southport Supply Rd, Southport, NC 28461-8742 |
| Kathleen May Franzen | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Street Address |
20 MEDICAL CAMPUS DR SUITE 204 |
| City | SUPPLY |
| State | NC |
| Zip | 28462-0001 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rita M Desimone | Occupational Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Mary F Stoker | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Thomas Lair | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Kurt Kildow | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Scott Thomas | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Brittainy R Edwards Kidlow | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Kathleen May Franzen | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Vaughn Leigh Moore | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Erin Brooke Bostic | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Supply, NC 28462-0001 |
| Richard James Brannin Jr. | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Supply, NC 28462-0001 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tamara Michelle Bivins | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Mark A Lizak | Ophthalmology | 14 Medical Ctr Dr, Supply, NC 28462-3350 | |
| Richard D Crane | Internal Medicine | 16 Medical Ctr Dr, Supply, NC 28462-3350 | |
| Celeste M Cianciulli | Clinical Social Worker | 5 Medical Ctr Dr, Supply, NC 28462-3350 | |
| Nicholas Alan Bailey | Qualified Audiologist | Coastal Hearing Centers, Inc | 2298 Ocean Hwy W, Supply, NC 28462-4024 |
| Joshua David Cillo | Qualified Audiologist | Coastal Hearing Centers, Inc | 2298 Ocean Hwy W, Supply, NC 28462-4024 |
| James Dimuzio Jr. | Otolaryngology | Coastal Carolina Ent Do Pa | 2298 Ocean Hwy W, Supply, NC 28462-4024 |
| Marie M Wheatley | Nurse Practitioner | Coastal Carolina Ent Do Pa | 2298 Ocean Hwy W, Supply, NC 28462-4024 |
| Jeffrey Coury | Otolaryngology | Coastal Carolina Ent Do Pa | 2298 Ocean Hwy W, Supply, NC 28462-4024 |
| Jayna Shashikant Patel | Otolaryngology | Coastal Carolina Ent Do Pa | 2298 Ocean Hwy W, Supply, NC 28462-4024 |
| Find all physicians in zip 28462 | |||
| City | SUPPLY |
| Zip Code | 28462 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | SUPPLY + PHYSICAL THERAPY |
Please comment or provide details below to improve the information on Benjamin Clark.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.