DESTINY CLARK
NPI 1700578010
Prosthetic/Orthotic Supplier in Ridgeland, MS

Q: What is Destiny Clark's NPI number?

The NPI number for Destiny Clark is 1700578010. It was assigned to this individual provider in the NPPES registry on May 24, 2023.

Q: What is Destiny Clark's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

Q: When was this NPI record last updated?

The NPPES record for Destiny Clark was last updated on May 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 24, 2023

6811 OLD CANTON RD APT 3305, RIDGELAND, MS 39157(769) 231-7366 Get Directions Write a Review

NPPES record last updated: May 24, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Destiny Clark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DESTINY CLARK (NPI 1700578010) is an individual prosthetic/orthotic supplier provider in Ridgeland, Mississippi and active in the NPI registry since May 2023.

NPPES Registry Identity

NPI1700578010

Entity TypeIndividualFemale

Primary Taxonomy335E00000X

Provider Legal NameDESTINY CLARK

Location Address6811 OLD CANTON RD APT 3305Ridgeland, MS 39157-1247

Mailing Address4780 I 55 N Ste 100 Pmb 2296Jackson, MS 39211-5583 · (601) 790-1738

Phone(769) 231-7366

Sole ProprietorYes

Enumeration DateMay 24, 2023

NPPES CertifiedMay 24, 2023

✔ NPI 1700578010 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyProsthetic/Orthotic SupplierSuppliers

Taxonomy Code335E00000X

Definition

An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

6811 OLD CANTON RD APT 3305, Ridgeland, MS 39157

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Destiny Clark's NPI number?

The NPI number for Destiny Clark is 1700578010. It was assigned to this individual provider in the NPPES registry on May 24, 2023.

Where is Destiny Clark located?

Destiny Clark practices at 6811 Old Canton Rd Apt 3305, Ridgeland, MS 39157. The listed phone number is (769) 231-7366.

What is Destiny Clark's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

When was this NPI record last updated?

The NPPES record for Destiny Clark was last updated on May 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.