Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Charles Clark Jr., PT

Individual provider Physical Therapist · NPI 1225052210

Mr. Charles Clark Jr., PT is a Physical Therapist in Private Practice in Louisville, Kentucky. Qualified in 1997, 29 years ago. Practices with Benchmark Physical Therapy of Ky LLC, a 55-clinician group and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
29
Licensed in
KY
In the registry since
2006
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

805 Blankenbaker Pkwy Ste 107
Louisville, KY 40243-1894
Phone: (502) 253-0833
Fax: (502) 253-0834
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 003320 (KY)

Record details

NPI number1225052210
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedJuly 26, 2006
Last updated in NPPESAugust 13, 2019

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Benchmark Physical Therapy Of Ky Llc — 55 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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