Ebony Jackson Clark, - Medicare Physical Therapist in Casa Grande, AZ

Ebony Jackson Clark, is a medicare enrolled "Physical Therapist" provider in Casa Grande, Arizona. Her current practice location is 1828 E Florence Blvd Ste 102, Casa Grande, Arizona. You can reach out to her office (for appointments etc.) via phone at (520) 510-0360.

Ebony Jackson Clark is licensed to practice in Pennsylvania (license number PT027785) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1417502766.

Contact Information

Ebony Jackson Clark,
1828 E Florence Blvd Ste 102,
Casa Grande, AZ 85122-4783
(520) 510-0360
Not Available



Healthcare Provider's Profile

Full NameEbony Jackson Clark
GenderFemale
SpecialityPhysical Therapist
Location1828 E Florence Blvd Ste 102, Casa Grande, Arizona
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1417502766
  • Provider Enumeration Date: 08/05/2019
  • Last Update Date: 04/08/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 4587067053
  • Enrollment ID: I20210721001001

Medical Identifiers

Medical identifiers for Ebony Jackson Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1417502766NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225100000XPhysical Therapist PT027785 (Pennsylvania)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ebony Jackson Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ebony Jackson Clark,
1828 E Florence Blvd Ste 102,
Casa Grande, AZ 85122-4783

Ph: () -
Ebony Jackson Clark,
1828 E Florence Blvd Ste 102,
Casa Grande, AZ 85122-4783

Ph: (520) 510-0360

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› Verified 9 days ago


Physical Therapist in Casa Grande, AZ

Kyle Flood, DPT
Physical Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 580 N Camino Mercado Ste 25, Casa Grande, AZ 85122
Phone: 855-331-7522    
Ari David Goldstein, PT
Physical Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 1295 E Florence Blvd Ste 1-3, Casa Grande, AZ 85122
Phone: 520-494-3058    Fax: 520-214-5059
Cory C Mckinnon, P.T.
Physical Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 580 N Camino Mercado Ste 13, Casa Grande, AZ 85122
Phone: 520-836-8621    
Andrew Laughlin, PT, DPT
Physical Therapist
Medicare: Medicare Enrolled
Practice Location: 1828 E Florence Blvd, Casa Grande, AZ 85122
Phone: 520-510-0360    
Corey Shaun Brinton, PT, DPT
Physical Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 580 N Camino Mercado Ste 13, Casa Grande, AZ 85122
Phone: 520-836-8621    
Trevor Dickman,
Physical Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 1828 E Florence Blvd, Casa Grande, AZ 85122
Phone: 520-510-0360    
Dr. Eric Johnson, PT, DPT
Physical Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 580 N Camino Mercado Ste 25, Casa Grande, AZ 85122
Phone: 855-331-7522    

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