Individual provider Active NPI

Dana Lorraine Cavell Clum, D.C.

  • Chiropractor
  • Patchogue, NY
National Provider Identifier
1053612655
Registry record updated Nov 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X010114-1 Issued in NY
Practice address
585 Medford Ave Ste 10
Patchogue, NY 11772-1336
Phone
(631) 569-5476
Fax
(631) 569-5478
NPI assigned
Nov 12, 2010
Last updated
Nov 12, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X010114-1 NY Primary

Addresses

Primary practice location

585 Medford Ave Ste 10
Patchogue, NY 11772-1336

Mailing address

585 Medford Ave Ste 10
Patchogue, NY 11772-1336
Phone (631) 569-5476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150616002263 WA Practitioner - Chiropractic 1254642374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dana Clum and Associates PLLCGroup PAC ID 5395025399, 2 clinicians

Practice addresses (Care Compare)

13128 Totem Lake Blvd NE
Suite 203
Kirkland, WA 98034-2953
Phone (425) 820-8837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X010114-1NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dana Clum and Associates, PLLC Chiropractor CurrentSince Dec 8, 2016 Accepting new patients
Abundant Health Chiropractic PC Chiropractor Past Accepting new patients

Locations

13128 Totem Lake Blvd NE
Ste 203
Kirkland, WA 98034
Phone (425) 820-8837

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289520000000",
    "number": "1053612655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 MEDFORD AVE STE 10",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721336",
            "telephone_number": "631-569-5476",
            "fax_number": "631-569-5478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 MEDFORD AVE STE 10",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721336",
            "telephone_number": "631-569-5476",
            "fax_number": "631-569-5478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVELL CLUM",
        "first_name": "DANA",
        "middle_name": "LORRAINE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-12",
        "last_updated": "2010-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010114-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.