Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Jackie Clark

Individual provider Occupational Therapist · NPI 1124474457

Jackie Clark is registered under Occupational Therapist in Private Practice in Parrish, Florida. Qualified in 2010, 16 years ago. Accepts Medicare assignment. Licensed in Florida.

Years since qualifying
16
Licensed in
FL
In the registry since
2016
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Practice location Address checks out

11472 Walden Loop
Parrish, FL 34219-7565
Phone: (941) 806-7555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence OT14395 (FL)

Record details

NPI number1124474457
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 5, 2016
Last updated in NPPESDecember 6, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients12
Average patient age79

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Other providers in Parrish