Individual provider Active NPI

Ronald E Clary Jr., D.C.

  • Chiropractor
  • Providence, RI
National Provider Identifier
1093842684
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DCP00546 Issued in RI
Practice address
154 Waterman St Ste 1B
Providence, RI 02906-3116
Phone
(401) 415-9585
Fax
(401) 415-9586
NPI assigned
Feb 28, 2007
Last updated
Feb 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DCP00546 RI Primary

Addresses

Primary practice location

154 Waterman St Ste 1B
Providence, RI 02906-3116

Mailing address

154 Waterman St Ste 1B
Providence, RI 02906-3116
Phone (401) 415-9585

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080211000394 RI Practitioner - Chiropractic 2163511940 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
3134MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Doherty Chiropractic Chiropractor Past Accepting new patients
Khoury Chiropractic, Inc. Chiropractor PastSince Jun 11, 2002 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.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1093842684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 WATERMAN ST STE 1B",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029063116",
            "telephone_number": "401-415-9585",
            "fax_number": "401-415-9586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 WATERMAN ST STE 1B",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029063116",
            "telephone_number": "401-415-9585",
            "fax_number": "401-415-9586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARY",
        "first_name": "RONALD",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "RI",
            "license": "DCP00546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.