Individual provider Active NPI

Camille McClendon

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1649792540
Registry record updated Jul 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2017015798 Issued in MO
Practice address
9717 Landmark Parkway Dr Ste 216
Saint Louis, MO 63127-1633
Phone
(314) 849-4120
NPI assigned
Jul 12, 2017
Last updated
Jul 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2017015798 MO Primary

Addresses

Primary practice location

9717 Landmark Parkway Dr Ste 216
Saint Louis, MO 63127-1633

Mailing address

5027 Aubert Ave
Saint Louis, MO 63115-1804

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250206002633 TX Practitioner - Chiropractic 9133659006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Integrated Healthcare, PLLCGroup PAC ID 4183969082, 4 clinicians

Practice addresses (Care Compare)

3334 N Town E Blvd
Suite 102
Mesquite, TX 75150-3800
Phone (972) 681-8321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14568TXMDCounselor
2017015798MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
American Chiropractic Clinic Chiropractor CurrentSince Dec 5, 2024 Accepting new patients
American Integrated Healthcare PLLC Chiropractor CurrentSince Dec 5, 2024 Accepting new patients

Locations

3334 N Town East Blvd
Ste 102
Mesquite, TX 75150
Phone (972) 681-8321

Organizations & group practices 2

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": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499817600000",
    "number": "1649792540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5027 AUBERT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631151804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9717 LANDMARK PARKWAY DR STE 216",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271633",
            "telephone_number": "314-849-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLENDON",
        "first_name": "CAMILLE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2017-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2017015798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2017; 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.