Individual provider Active NPI

Clinton J Garda, DC

  • Chiropractor
  • Cincinnati, OH
National Provider Identifier
1417084286
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4284 Issued in OH
Practice address
9879 Montgomery Road
Cincinnati, OH 45242
Phone
(513) 891-2111
Fax
(513) 891-2113
NPI assigned
Feb 27, 2007
Last updated
Dec 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-008673 IL
Chiropractor 111N00000X 4284 OH Primary

Addresses

Primary practice location

9879 Montgomery Road
Cincinnati, OH 45242

Mailing address

9879 Montgomery Road
Cincinnati, OH 45242
Phone (513) 891-2111

Other identifiers 2

IdentifierTypeStateIssuer
K39401OtherILMEDICARE ID #
5632232OtherILBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121220000329 OH Practitioner - Chiropractic 5193826931 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellness DocsGroup PAC ID 1254758592, 8 clinicians

Practice addresses (Care Compare)

11123 Montgomery Rd
Suite 105
Cincinnati, OH 45249-2390
Phone (513) 342-1700

9879 Montgomery Rd
Montgomery, OH 45242-6424
Phone (513) 891-2111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-008673ILMDChiropractor
4284OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Docs CurrentSince Jul 8, 2025 Accepting new patients
Backbone Wellness Institute LLC CurrentSince Nov 27, 2012 Accepting new patients
Chiro One Wellness Center of Crystal Lake SC Chiropractor PastSince Aug 1, 2016 Accepting new patients

Locations

11123 Montgomery Rd
Ste 105
Cincinnati, OH 45249
Phone (513) 342-1700

3328 Princeton Rd
Fairfield Township, OH 45011
Phone (513) 342-1700

9879 Montgomery Rd
Montgomery, OH 45242
Phone (513) 891-2111

Organizations & group practices 3

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1417084286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9879 MONTGOMERY ROAD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45242",
            "telephone_number": "513-891-2111",
            "fax_number": "513-891-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9879 MONTGOMERY ROAD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45242",
            "telephone_number": "513-891-2111",
            "fax_number": "513-891-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDA",
        "first_name": "CLINTON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-008673",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID #",
            "identifier": "K39401",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5632232",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.