DE'ATRA PRUETT CLARK OT
NPI 1164427209
Occupational Therapist in Jacksonville, FL
NPI Status: Active since June 16, 2005
Contact Information
1325 SAN MARCO BLVD
STE 102
JACKSONVILLE, FL
ZIP 32207
Phone: (904) 858-7045
Fax: (904) 858-7047
- Individual
- Female
- Occupational Therapist
- Accepts Insurance
About DE'ATRA CLARK
This page provides the complete NPI Profile along with additional information for De'atra Clark, a provider established in Jacksonville, Florida with a medical specialization in Occupational Therapist. The healthcare provider is registered in the NPI registry with number 1164427209 assigned on June 2005. The practitioner's primary taxonomy code is 225X00000X with license number OT0007576 (FL). The provider is registered as an individual and her NPI record was last updated 19 years ago.
- NPI
- 1164427209
- Provider Name
- DE'ATRA PRUETT CLARK OT
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1325 SAN MARCO BLVD STE 102 JACKSONVILLE, FL 32207
- Location Phone
- (904) 858-7045
- Location Fax
- (904) 858-7047
- Mailing Address
- 1325 SAN MARCO BLVD SUITE 701 JACKSONVILLE, FL 32207
- Mailing Phone
- (904) 858-6418
- Mailing Fax
- (904) 858-7047
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-16-2005
- Last Update Date
- 07-08-2007
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Occupational Therapist
- Taxonomy Code
- 225X00000X
- Type
- Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- License No.
- OT0007576
- License State
- FL
- Taxonomy Description
- An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- AvMed Entrust Bronze 600 (2026) - HMO
- AvMed Entrust Bronze 650 (2026) - HMO
- AvMed Entrust Expanded Bronze Standard (2026) - HMO
- AvMed Entrust Gold 125 (2026) - HMO
- AvMed Entrust Gold 125 Dental+Vision (2026) - HMO
- AvMed Entrust Gold Standard (2026) - HMO
- AvMed Entrust Platinum 25 (2026) - HMO
- AvMed Entrust Platinum 25 Dental+Vision (2026) - HMO
- AvMed Entrust Platinum Standard (2026) - HMO
- AvMed Entrust Silver 350 (2026) - HMO
- AvMed Entrust Silver 350 Dental+Vision (2026) - HMO
- AvMed Entrust Silver 550 (2026) - HMO
- AvMed Entrust Silver 550 Dental+Vision (2026) - HMO
- AvMed Entrust Silver Standard (2026) - HMO
- Bronze Classic 4700 - HMO
- Bronze Classic 4700 | with AdventHealth - HMO
- Bronze Classic Standard - HMO
- Bronze Classic Standard | with AdventHealth - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Elite + PCP Saver Plus | with AdventHealth - HMO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Bronze Simple Chronic Care CKM - HMO
- Bronze Simple Diabetes - HMO
- Gold Classic Standard - HMO
- Gold Classic Standard | with AdventHealth - HMO
- Gold Elite Saver Plus | with AdventHealth - HMO
- Gold Simple - HMO
- Gold Simple | with AdventHealth - HMO
- Silver Classic Standard - HMO
- Silver Classic Standard | with AdventHealth - HMO
- Silver Elite - HMO
- Silver Elite | with AdventHealth - HMO
- Silver Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Silver Simple Chronic Care CKM - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1164427209, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 51 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
JACKSONVILLE, FL 32207
JACKSONVILLE, FL 32207
JACKSONVILLE, FL 32207
JACKSONVILLE, FL 32207
JACKSONVILLE, FL 32207
JACKSONVILLE, FL 32207
JACKSONVILLE, FL 32207
JACKSONVILLE, FL 32207
JACKSONVILLE, FL 32207
JACKSONVILLE, FL 32207
JACKSONVILLE, FL 32207
JACKSONVILLE, FL 32207
JACKSONVILLE, FL 32207
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1164427209, enumerated as an "individual" on June 16, 2005.
The provider is located at 1325 SAN MARCO BLVD STE 102 JACKSONVILLE, FL 32207 and the phone number is (904) 858-7045.
Occupational Therapist with taxonomy code 225X00000X.
The provider might be accepting Accepts: AvMed and Oscar Health Maintenance Organization of. Please consult your insurance carrier or call the provider to verify.
