Active NPI
Thor Man Clemens
- Chiropractor
- Nevada City, CA
National Provider Identifier
1205580925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 35111
- Practice address
- 355 Providence Mine Rd
Nevada City, CA 95959-2980 - Phone
- (530) 264-7571
- NPI assigned
- Feb 10, 2022
- 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 | 35111 | CA | Primary |
Addresses
Primary practice location
355 Providence Mine Rd
Nevada City, CA 95959-2980
Mailing address
355 Providence Mine Rd
Nevada City, CA 95959-2980
Phone (530) 264-7571
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | DESKTOP-85H43MK | Direct |
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 |
|---|---|---|---|
| 35111 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644451200000",
"number": "1205580925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 PROVIDENCE MINE RD",
"city": "NEVADA CITY",
"state": "CA",
"postal_code": "959592980",
"telephone_number": "530-264-7571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 PROVIDENCE MINE RD",
"city": "NEVADA CITY",
"state": "CA",
"postal_code": "959592980",
"telephone_number": "530-264-7571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMENS",
"first_name": "THOR",
"middle_name": "MAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-02-10",
"last_updated": "2022-02-10",
"certification_date": "2022-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "35111",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "DESKTOP-85H43MK",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "355 Providence Mine Rd",
"city": "Nevada City",
"state": "CA",
"country_code": "US",
"postal_code": "959592980",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Nevada City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.