Active NPI
Charles Clark Jr., D.C.
- Chiropractor
- Glendale, AZ
National Provider Identifier
1003119272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 7094
- Practice address
- 16222 N 59TH Ave
Suite A100
Glendale, AZ 85306-1705 - Phone
- (623) 334-4000
- Fax
- (623) 334-4400
- NPI assigned
- Dec 10, 2010
- Last updated
- Feb 8, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 7094 | AZ | Primary |
Addresses
Primary practice location
16222 N 59TH Ave
Suite A100
Glendale, AZ 85306-1705
Mailing address
16222 N 59TH Ave
Suite A100
Glendale, AZ 85306-1705
Phone (623) 334-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zeiler Chiropractic PC | Chiropractor | Past | Accepting new patients |
| Physical Medicine of Scottsdale, LLC | Past | Accepting new patients | |
| Southwest Centers for Natural Healing | Chiropractor | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Arizona Pain Relief
- General Practice Physician
- Scottsdale, AZ
- NPI 1558710152
-
dba Palmer Center for Natural Healing
- Chiropractor
- Scottsdale, AZ
- NPI 1629117379
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486512000000",
"number": "1003119272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16222 N 59TH AVE",
"address_2": "SUITE A100",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853061705",
"telephone_number": "623-334-4000",
"fax_number": "623-334-4400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16222 N 59TH AVE",
"address_2": "SUITE A100",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853061705",
"telephone_number": "623-334-4000",
"fax_number": "623-334-4400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "CHARLES",
"name_suffix": "Jr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-12-10",
"last_updated": "2017-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AZ",
"license": "7094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.