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

Patrick Thomas Clark

Individual provider Physical Therapist · NPI 1417682618

Patrick Thomas Clark is a Physical Therapist in Private Practice in Buckeye, Arizona. Qualified in 2022, 4 years ago. Works from 2 locations and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2022
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Practice location Address checks out

825 S Watson Rd Ste 106
Buckeye, AZ 85326-3435
Phone: (623) 207-4015
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2615 Woodruff Rd Ste 400, Simpsonville, SC 29681-6828 — (864) 537-5016

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1417682618
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 21, 2022
Last updated in NPPESOctober 29, 2024
Certification dateOctober 29, 2024
Mailing address790 Remington Blvd, Bolingbrook, IL 60440-4909

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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