Active NPI
Jacqueline Joy McClenny, D.C.
- Chiropractor
- Southport, NC
National Provider Identifier
1639197916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3349
- Practice address
- 1635 N Howe St
# JK
Southport, NC 28461-8372 - Phone
- (910) 454-4041
- NPI assigned
- Jul 17, 2006
- Sex
- Female
- 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 | 3349 | NC | Primary |
Addresses
Primary practice location
1635 N Howe St
# JK
Southport, NC 28461-8372
Mailing address
4870 Long Beach Rd SE # 1
Southport, NC 28461-8713
Phone (910) 454-4041
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050518000186 | NC | Practitioner - Chiropractic | 3375584527 | Practice locations: Southport, NC |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Sherman College of Straight Chiropractic, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1635 N Howe St
JK
Southport, NC 28461-8372
Phone (910) 454-4041
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3349 | NC | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640649600000",
"number": "1639197916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4870 LONG BEACH RD SE # 1",
"city": "SOUTHPORT",
"state": "NC",
"postal_code": "284618713",
"telephone_number": "910-454-4041",
"fax_number": "910-454-4044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 N HOWE ST",
"address_2": "# JK",
"city": "SOUTHPORT",
"state": "NC",
"postal_code": "284618372",
"telephone_number": "910-454-4041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLENNY",
"first_name": "JACQUELINE",
"middle_name": "JOY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-17",
"last_updated": "2021-12-28",
"certification_date": "2021-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "3349",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southport, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; 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.