Active NPI
Clint Bennion, DC
- Chiropractor
- Mesa, AZ
National Provider Identifier
1407872930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 7279
- Practice address
- 1303 S Longmore
Suite #8
Mesa, AZ 85202-9607 - Phone
- (480) 649-5297
- Fax
- (480) 539-4685
- NPI assigned
- Jul 15, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 7279 | AZ | Primary |
Addresses
Primary practice location
1303 S Longmore
Suite #8
Mesa, AZ 85202-9607
Mailing address
1303 S Longmore
Suite #8
Mesa, AZ 85202-9607
Phone (480) 649-5297
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7279 | AZ | MD | Endocrinology, Diabetes & Metabolism Physician |
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": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407872930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1303 S LONGMORE",
"address_2": "SUITE #8",
"city": "MESA",
"state": "AZ",
"postal_code": "852029607",
"telephone_number": "480-649-5297",
"fax_number": "480-539-4685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1303 S LONGMORE",
"address_2": "SUITE #8",
"city": "MESA",
"state": "AZ",
"postal_code": "852029607",
"telephone_number": "480-649-5297",
"fax_number": "480-539-4685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNION",
"first_name": "CLINT",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AZ",
"license": "7279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.