Individual provider Active NPI

Benjamin Alan McClintock, D.C.

  • Chiropractor
  • Muskegon, MI
National Provider Identifier
1174981674
Registry record updated Jan 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010393 Issued in MI
Practice address
1159 E Laketon Ave
Muskegon, MI 49442-6024
Phone
(231) 726-6355
NPI assigned
Jan 29, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2301010393 MI Primary

Addresses

Primary practice location

1159 E Laketon Ave
Muskegon, MI 49442-6024

Mailing address

1159 E Laketon Ave
Muskegon, MI 49442-6024
Phone (231) 726-6355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160427002217 MI Practitioner - Chiropractic 8921307844

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301010393MIMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1174981674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1159 E LAKETON AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494426024",
            "telephone_number": "231-726-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1159 E LAKETON AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494426024",
            "telephone_number": "231-726-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLINTOCK",
        "first_name": "BENJAMIN",
        "middle_name": "ALAN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-29",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; 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.