Individual provider Active NPI

Kristina Leigh Clinton, DC

  • Chiropractor
  • Cedar Park, TX
National Provider Identifier
1639186737
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8565 Issued in TX
Practice address
3109 Kenai Dr Ste 101
Cedar Park, TX 78613-2540
Phone
(512) 363-5178
Fax
(512) 339-2664
NPI assigned
Aug 2, 2006
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8565 TX Primary

Addresses

Primary practice location

3109 Kenai Dr Ste 101
Cedar Park, TX 78613-2540

Mailing address

3109 Kenai Dr Ste 101
Cedar Park, TX 78613-2540
Phone (512) 363-5178

Other identifiers 1

IdentifierTypeStateIssuer
607005OtherTXBCBS PROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190513000609 TX Practitioner - Chiropractic 7214270305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3109 Kenai Dr
Suite 101
Cedar Park, TX 78613-2540
Phone (512) 363-5178

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8565TXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kristy L Clinton DC PA Chiropractor CurrentSince Apr 1, 2019 Accepting new patients
Tracie L Schwab DC PA Chiropractor Past Accepting new patients
Emily Doubt Chiropractic PLLC Chiropractor PastSince Sep 3, 2013 Accepting new patients

Locations

12101 W Parmer Ln
Ste 200
Cedar Park, TX 78613
Phone (512) 363-5178

3109 Kenai Dr
Ste 101
Cedar Park, TX 78613
Phone (512) 363-5178

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1639186737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 KENAI DR STE 101",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132540",
            "telephone_number": "512-363-5178",
            "fax_number": "512-339-2664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 KENAI DR STE 101",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132540",
            "telephone_number": "512-363-5178",
            "fax_number": "512-339-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINTON",
        "first_name": "KRISTINA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "8565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "607005",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.