Individual provider Active NPI

Clayton Thomas Newberry, D.C.

  • Chiropractor
  • Kansas City, MO
National Provider Identifier
1669828208
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2016014932 Issued in MO
Practice address
125 NE 91St St
Kansas City, MO 64155-3329
Phone
(816) 436-7500
Fax
(816) 436-7501
NPI assigned
May 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2016014932 MO Primary

Addresses

Primary practice location

125 NE 91St St
Kansas City, MO 64155-3329

Mailing address

600 Broadway Blvd
Ste 175
Kansas City, MO 64105-1536
Phone (314) 238-6427

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160614001752 MO Practitioner - Chiropractic 2769771278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2425 N Old Atherton Rd
Independence, MO 64058-2009

310 S Platte Clay Way
Suite a
Kearney, MO 64060-8797

600 Broadway Blvd
Suite 175
Kansas City, MO 64105-1536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2016014932MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Restore Muscle and Joint, LLC CurrentSince Feb 27, 2023 Accepting new patients
Kelling Chiorpractic Center Chiropractor PastSince Nov 1, 2017 Accepting new patients

Locations

4119 NW Barry Rd
Kansas City, MO 64154
Phone (816) 452-4488

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1669828208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BROADWAY BLVD",
            "address_2": "STE 175",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641051536",
            "telephone_number": "314-238-6427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 NE 91ST ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641553329",
            "telephone_number": "816-436-7500",
            "fax_number": "816-436-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBERRY",
        "first_name": "CLAYTON",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-13",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2016014932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; 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.