Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Clark Brandon Rasberry, DPT

Individual provider Physical Therapist · NPI 1922136639

Mr. Clark Brandon Rasberry, DPT is a Physical Therapist in Private Practice in Laurel, Mississippi. Qualified in 2004, 22 years ago. Practices with Optimal Performance Physical Therapy, a 4-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
22
Licensed in
MS
In the registry since
2007
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

23 Mason St
Laurel, MS 39440-4437
Phone: (601) 399-0534
Fax: (601) 399-2810
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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 PT4025 (MS)

Record details

NPI number1922136639
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorYes
NPI enumeratedMarch 2, 2007
Last updated in NPPESJuly 8, 2007

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Optimal Performance Physical Therapy — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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