Individual provider Active NPI

Nathan Anthony Douglas McClain, D.C.

  • Chiropractor
  • Aztec, NM
National Provider Identifier
1619429206
Registry record updated Oct 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2152 Issued in NM
Practice address
1409 W Aztec Blvd
8
Aztec, NM 87410-4709
Phone
(505) 333-7929
Fax
(505) 333-7931
NPI assigned
Oct 29, 2016
Last updated
Oct 29, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2152 NM Primary

Addresses

Primary practice location

1409 W Aztec Blvd
8
Aztec, NM 87410-4709

Mailing address

1409 W Aztec Blvd
8
Aztec, NM 87410-4709
Phone (505) 333-7929

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180605002163 NM Practitioner - Chiropractic 9830454255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1409 W Aztec Blvd
Suite 8
Aztec, NM 87410-1874
Phone (505) 333-7929

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2152NMMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Adjusted Chiropractic Center Chiropractor CurrentSince Apr 7, 2018 Accepting new patients

Locations

1409 W Aztec Blvd
Ste 8
Aztec, NM 87410
Phone (505) 333-7929

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": "1477699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477699200000",
    "number": "1619429206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 W AZTEC BLVD",
            "address_2": "8",
            "city": "AZTEC",
            "state": "NM",
            "postal_code": "874104709",
            "telephone_number": "505-333-7929",
            "fax_number": "505-333-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 W AZTEC BLVD",
            "address_2": "8",
            "city": "AZTEC",
            "state": "NM",
            "postal_code": "874104709",
            "telephone_number": "505-333-7929",
            "fax_number": "505-333-7931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLAIN",
        "first_name": "NATHAN",
        "middle_name": "ANTHONY DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-29",
        "last_updated": "2016-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "2152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aztec, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2016; 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.