Active NPI
Clint Cordial, D.C.
- Chiropractor
- Missoula, MT
National Provider Identifier
1154601334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1265
- Practice address
- 701 W. Spruce
Missoula, MT 59802 - Phone
- (406) 721-8858
- Fax
- (406) 542-0960
- NPI assigned
- Aug 19, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1265 | MT | Primary |
Addresses
Primary practice location
701 W. Spruce
Missoula, MT 59802
Mailing address
701 W. Spruce
Missoula, MT 59802
Phone (406) 721-8858
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1265 | MT | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maureen Cordial, LMFT, LCPC, PLLC | Past | Accepting new patients | |
| Tim Cordial PT PC | Past | Accepting new patients |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313712000000",
"number": "1154601334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 W. SPRUCE",
"city": "MISSOULA",
"state": "MT",
"postal_code": "59802",
"telephone_number": "406-721-8858",
"fax_number": "406-542-0960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 W. SPRUCE",
"city": "MISSOULA",
"state": "MT",
"postal_code": "59802",
"telephone_number": "406-721-8858",
"fax_number": "406-542-0960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDIAL",
"first_name": "CLINT",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-19",
"last_updated": "2011-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MT",
"license": "1265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.