Kevin W. Cleary, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1647 Issued in AZ

Practice address

7725 N 43Rd Ave Ste 720
Phoenix, AZ 85051-5772

Phone

(623) 207-5465

Fax

(623) 207-5405

NPI assigned

May 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1174573000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7725 N 43RD AVE",
            "address_2": "STE 720",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850515772",
            "telephone_number": "623-207-5465",
            "fax_number": "623-207-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7725 N 43RD AVE STE 720",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850515772",
            "telephone_number": "623-207-5465",
            "fax_number": "623-207-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEARY",
        "first_name": "KEVIN",
        "middle_name": "W.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "1647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "241026",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clear Path Integrated Clinic
• Clear Solutions Hospice Inc
• Clear Vision Ophthalmology PC
• Clearfire LLC
• Clearpath Family Health LTD
• Aaron James Cleavenger, RN
• Patricia Anne Clees
• Karen Rudel Cleeves-Estabrook, OTR/L
• Melissa C Clem
• Andrea Lynne Clemens, OTD, OTR/L

• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.