Individual provider Active NPI

Clark James Hadley, DC

  • Chiropractor
  • Rochester, NY
National Provider Identifier
1093292591
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
013129 Issued in NY
Practice address
428 White Spruce Blvd
Rochester, NY 14623-1608
Phone
(585) 272-1480
Fax
(585) 272-0275
NPI assigned
Jul 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 013129 NY Primary

Addresses

Primary practice location

428 White Spruce Blvd
Rochester, NY 14623-1608

Mailing address

428 White Spruce Blvd
Rochester, NY 14623-1608
Phone (585) 272-1480

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180919003345 NY Practitioner - Chiropractic 6406107143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Howard Hadley DC PCGroup PAC ID 7012284920, 3 clinicians

Practice addresses (Care Compare)

428 White Spruce Blvd
Rochester, NY 14623-1608
Phone (585) 272-1480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013129NYMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Hadley DC PC Chiropractor CurrentSince Sep 1, 2018 Accepting new patients
Odell Family Chiropractic PC Chiropractor PastSince Sep 1, 2018 Accepting new patients

Locations

428 White Spruce Blvd
Rochester, NY 14623
Phone (585) 272-1480

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1093292591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 WHITE SPRUCE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146231608",
            "telephone_number": "585-272-1480",
            "fax_number": "585-272-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 WHITE SPRUCE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146231608",
            "telephone_number": "585-272-1480",
            "fax_number": "585-272-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADLEY",
        "first_name": "CLARK",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "013129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; 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.