Clisby Chiropractic, Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC-30596 Issued in CA

Legal business name

CLISBY CHIROPRACTIC, INC

Practice address

100 W Broadway
Ste. 1400
Long Beach, CA 90802-4431

Phone

(562) 495-2121

Fax

(562) 495-3131

NPI assigned

May 14, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Kerry Clisby Jr., D.C.NPI 1881883155

Title

Doctor

Phone

(562) 495-2121

Specialties & licenses 1

Addresses

Other names 1

• Beachside Wellness Group Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kerry Louis Clisby Jr., D.C.

  • Chiropractor
  • Long Beach, CA
  • NPI 1881883155
  NPD (past) Authorized official

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

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273795200000",
    "number": "1104144112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W BROADWAY",
            "address_2": "STE. 1400",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024431",
            "telephone_number": "562-495-2121",
            "fax_number": "562-495-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W BROADWAY",
            "address_2": "STE. 1400",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024431",
            "telephone_number": "562-495-2121",
            "fax_number": "562-495-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLISBY CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-14",
        "last_updated": "2010-05-14",
        "status": "A",
        "authorized_official_last_name": "CLISBY",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "562-495-2121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-30596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beachside Wellness Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Regina A. Clifton, RN - NP
• Jessica H Clinard-Allmen
• Charlene Heather Cline, LCSW
• Ebony Danielle Clinton
• Rachel Clinton
• Dionne Clisby, DC
• Kerry Louis Clisby Jr., D.C.
• Clnica Uriel / Iradj Nazarian MD
• Crystal Faye Clopton
• Brandon Lee Clough

• All providers in Long Beach, CA
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.