Individual provider Active NPI

Clay Donovan Warren, D.C.

  • Chiropractor
  • Mesa, AZ
National Provider Identifier
1124032339
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7723 Issued in AZ
Practice address
7227 E Baseline Rd
Ste 106
Mesa, AZ 85209-5005
Phone
(480) 832-5777
Fax
(480) 584-4046
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7723 AZ Primary

Addresses

Primary practice location

7227 E Baseline Rd
Ste 106
Mesa, AZ 85209-5005

Mailing address

7227 E Baseline Rd
Ste 106
Mesa, AZ 85209-5005
Phone (480) 832-5777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070102000402 AZ Practitioner - Chiropractic 7113948787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Physical Medicine LLCGroup PAC ID 2567749013, 2 clinicians

Practice addresses (Care Compare)

7227 E Baseline Rd
Suite 106
Mesa, AZ 85209-5005
Phone (480) 832-5777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7723AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Physical Medicine, LLC Chiropractor CurrentSince Jan 5, 2017 Accepting new patients
Emmert Chiropractic Company Past Accepting new patients
CDW Chiropractic PC Chiropractor PastSince May 15, 2006 Accepting new patients
Emmert Chiropractic Company Chiropractor PastSince Sep 7, 2016 Accepting new patients

Locations

7227 E Baseline Rd
Ste 106
Mesa, AZ 85209
Phone (480) 832-5777

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4684/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1124032339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 E BASELINE RD",
            "address_2": "STE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852095005",
            "telephone_number": "480-832-5777",
            "fax_number": "480-584-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7227 E BASELINE RD",
            "address_2": "STE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852095005",
            "telephone_number": "480-832-5777",
            "fax_number": "480-584-4046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "CLAY",
        "middle_name": "DONOVAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; 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.