1. Home
  2. Directory
  3. Pennsylvania
  4. Moon Township
  5. Physical Therapist
  6. NPI Profile
  7. NPI Record 1114187796

ALEXIS ANNE CLARK PT,DPT
Complete NPI Record 1114187796
Physical Therapist in Moon Township, PA


Quality Rating: 80.77 out of 100 score

NPI Status: Active since June 17, 2008

Contact Information

860 BEAVER GRADE RD STE C
MOON TOWNSHIP, PA
ZIP 15108
Phone: (878) 999-9013

Get Directions

Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Credential Text
  7. Provider Other Last Name
  8. Provider Other First Name
  9. Provider Other Middle Name
  10. Provider Other Credential Text
  11. Provider Other Last Name Type Code
  12. Provider First Line Business Mailing Address
  13. Provider Business Mailing Address City Name
  14. Provider Business Mailing Address State Name
  15. Provider Business Mailing Address Postal Code
  16. Provider Business Mailing Address Country Code If outside U S
  17. Provider Business Mailing Address Telephone Number
  18. Provider First Line Business Practice Location Address
  19. Provider Business Practice Location Address City Name
  20. Provider Business Practice Location Address State Name
  21. Provider Business Practice Location Address Postal Code
  22. Provider Business Practice Location Address Country Code If outside U S
  23. Provider Business Practice Location Address Telephone Number
  24. Provider Enumeration Date
  25. Last Update Date
  26. Provider Gender Code
  27. Healthcare Provider Taxonomy Code 1
  28. Provider License Number 1
  29. Provider License Number State Code 1
  30. Healthcare Provider Primary Taxonomy Switch 1
  31. Is Sole Proprietor
  32. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1114187796. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1114187796
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: ALEXIS
The first name of the provider, if the provider is an individual.
Provider Middle Name: ANNE
The middle name of the provider, if the provider is an individual.
Provider Credential Text: PT,DPT
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Other Last Name: DOMHOFF
Other last name by which the provider being identified is or has been known.
Provider Other First Name: ALEXIS
Other first name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider first name’’ if the provider is or has been known by a different last name only.
Provider Other Middle Name: ANNE
Other middle name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider middle name’’ if the provider is or has been known by a different last name only.
Provider Other Credential Text: PT,DPT
The other abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Other Last Name Type Code: 1
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: 1200 CORPORATE DR STE 400
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: HOOVER
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: AL
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 352425424
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Country Code If outside U S : US
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider Business Mailing Address Telephone Number: 4234970005
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address: 860 BEAVER GRADE RD STE C
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: MOON TOWNSHIP
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: PA
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 151082639
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number: 8789999013
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/17/2008
The telephone number associated with the location address of the provider being identified.
Last Update Date: 11/19/2024
The date that a record was last updated or changed.
Provider Gender Code: F
The date that a record was last updated or changed.
Healthcare Provider Taxonomy Code 1: 225100000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: PT 022571
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number State Code 1: PA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
NPI Certification Date: 11/19/2024