Adam Craig McClellan, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

2010016137 Issued in MO

Practice address

650 E 25TH St
Kansas City, MO 64108-2716

Phone

(816) 235-2147

Fax

(816) 235-5472

NPI assigned

Apr 9, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333929600000",
    "number": "1568728194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 E 25TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082716",
            "telephone_number": "816-235-2147",
            "fax_number": "816-235-5472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E 25TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082716",
            "telephone_number": "816-235-2147",
            "fax_number": "816-235-5472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "ADAM",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-09",
        "last_updated": "2012-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MO",
            "license": "2010016137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rance McClain, D.O.
• Donna Joy McClanahan, RNC, PNP, MSN
• Valerie Klejch McClaran, CRNA
• John McCleary, CRNA
• Ruth McCleery, CPD
• Aubreona McClellan
• Jackie Nichole McClellan, LPC
• Valyn Faith McClellan
• Gus McClelland, MSW
• Kristie L McClendon

• Periodontics in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Periodontics in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.