Individual provider Active NPI

Kelly D Clenney, D.C.

  • Chiropractor
  • Amarillo, TX
National Provider Identifier
1356353346
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7116 Issued in TX
Practice address
3701 Olsen Blvd Unit D
Amarillo, TX 79109-3053
Phone
(806) 352-2976
Fax
(806) 352-2660
NPI assigned
Aug 11, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7116 TX Primary

Addresses

Primary practice location

3701 Olsen Blvd Unit D
Amarillo, TX 79109-3053

Mailing address

3701 Olsen Blvd Unit D
Amarillo, TX 79109-3053
Phone (806) 352-2976

Other identifiers 2

IdentifierTypeStateIssuer
7116OtherTXSTATE LICENSE #
82120XOtherTXBCBS

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7116TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Clenney Chiropractic PA Chiropractor Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1356353346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 OLSEN BLVD UNIT D",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791093053",
            "telephone_number": "806-352-2976",
            "fax_number": "806-352-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 OLSEN BLVD UNIT D",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791093053",
            "telephone_number": "806-352-2976",
            "fax_number": "806-352-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLENNEY",
        "first_name": "KELLY",
        "middle_name": "D",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "7116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "7116",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "82120X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.