DR. KELLY ANN CLARK (NPI# 1528614153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528614153 |
| Entity Type | Individual |
| Full Name | DR. KELLY ANN CLARK |
| Credential | DPT, PT, MT |
| Practice Address |
2620 N Walnut St Suite 600 Bloomington IN 47404-2008 |
| Practice Telephone | 8125580708 |
| Mailing Telephone | 8125580708 |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2019-08-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | 05013530A | IN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 225700000X | Massage Therapist | MT21304740 | IN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861026650 | Kelly Ann Clark | Nurse Practitioner | 4590 Childrens Pl, Saint Louis, MO 63110-1020 | 2020-03-02 |
| 1013474410 | Kelly Patricia Clark | Licensed Practical Nurse | 55 Pine Dr E, Mason, MI 48854-9229 | 2019-02-22 |
| 1013497304 | Kelly Ann Clark | Case Manager/Care Coordinator | 2498 Wenona Dr, Wixom, MI 48393-2199 | 2018-08-16 |
| 1407336720 | Kelly Elizabeth Clark | Physical Medicine & Rehabilitation | 3800 Reservoir Rd., Bles Building, Ground Floor, Department of Pm&r, Washington, DC 20007-2113 | 2018-08-16 |
| 1356747448 | Kelly Clark | Dietitian, Registered | 46 Mallards Cv, Duxbury, MA 02332-3548 | 2014-11-17 |
| 1568883312 | Kelly Clark | Licensed Practical Nurse | 125 W Bartlette St, Apt. 110, Sumter, SC 29150-5173 | 2013-12-20 |
| 1306105903 | Kelly Thomas Clark | Speech-Language Pathologist | 3406 Fowler Ct, Missouri City, TX 77459-6366 | 2012-05-16 |
| 1619247509 | Kelly Jane Clark | Pharmacist | 328 Quail Walk Trl, Chapin, SC 29036-9791 | 2012-01-09 |
| 1427350461 | Kelly Darlene Clark | Chiropractor | 2425 Mahan Dr, Tallahassee, FL 32308-2301 | 2010-11-24 |
| 1538479324 | Kelly S Clark | Licensed Vocational Nurse | 15716 W High St # 597, Middlefield, OH 44062-9201 | 2010-10-14 |
| Street Address |
2620 N WALNUT ST SUITE 600 |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47404-2008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588966485 | Gloria Ann Thompson | Social Worker | 2620 N Walnut St, Suite 370, Bloomington, IN 47404-2008 | 2010-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013526631 | Sandra Clark | Counselor | 205 N College Avenue, Suite 210a, Bloomington, IN 47404 | 2020-07-29 |
| 1750926085 | Michelle Christine Dustin | Nurse Practitioner | 610 N Morton Street, Bloomigton, IN 47404 | 2019-11-11 |
| 1316440191 | Julie D'argent | Psychologist | 205 N College Ave Ste 430, Bloomington, IN 47404 | 2018-03-17 |
| 1770966467 | Richard Lawson | Counselor | 1117 North Jackson Street, Bloomington, IN 47404 | 2015-06-30 |
| 1477952109 | Teresa R. Foster | Social Worker | 205 N. College Avenue, Suite 210b, Bloomington, IN 47404 | 2014-08-19 |
| 1073879532 | First Health Plus, Inc | Clinic/Center | 104 North Curry Pike, Bloomington, IN 47404 | 2012-04-09 |
| 1497079982 | Tera Dee Nance | Counselor | 101 W. Kirkwood Avenue, Suite 009 Fountain Square Mall, Bloomington, IN 47404 | 2010-03-26 |
| 1962643114 | Pathways Counseling Center | Community/Behavioral Health | 3866 W. Third Street, Bloomington, IN 47404 | 2009-03-18 |
| 1932358595 | Catherine Elizabeth Batka | Psychologist | 101 W. Kirkwood Ave, Suite 103, Bloomington, IN 47404 | 2008-09-18 |
| 1396901005 | Kijin Woo | Dentist | 330 N Jacob Drive, Bloomington, IN 47404 | 2008-08-01 |
| Find all providers in zip 47404 | ||||
| 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 |
|---|---|---|---|---|
| 1851900781 | Tana Van Meter | Physical Therapist | 3801 General Electric Rd, Bloomington, IL 61704-4182 | 2020-07-27 |
| 1558917088 | Brianna Blohm | Physical Therapist | 822 S Auto Mall Rd, Bloomington, IN 47401-5430 | 2019-08-12 |
| 1740765791 | Holly G Carter | Physical Therapist | 3607 Heirloom Dr, Bloomington, IN 47401 | 2018-09-26 |
| 1336625383 | Heidi Marie Cummins | Physical Therapist | 1402 Leslie Dr, Bloomington, IL 61704-5405 | 2018-07-12 |
| 1831692219 | Molly R Gill | Physical Therapist | 2103 N Veterans Pkwy Ste 332, Bloomington, IL 61704-0917 | 2018-03-13 |
| 1255848388 | Joy Alfonso | Physical Therapist | 450 S Stardust Cir, Bloomington, IN 47403-8707 | 2018-01-10 |
| 1619496536 | Kirsten N Neely | Physical Therapist | 2604 E. Creek's Edge Dr., Bloomington, IN 47401 | 2017-09-12 |
| 1023533908 | Hoosier United Therapy Service LLC | Physical Therapist | 2801 E Plateau Place, Bloomington, IN 47401 | 2017-08-11 |
| 1992231732 | Ethan Blankespoor | Physical Therapist | 3800 American Blvd W # 200, Bloomington, MN 55431-4420 | 2017-05-11 |
| 1649729625 | Emily White | Physical Therapist | 19 Lexis Ct, Bloomington, IL 61704-4814 | 2016-10-01 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 47404 |
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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.