Active NPI
Clinton Lane Kinnear, D.C.
- Chiropractor
- Carlsbad, CA
National Provider Identifier
1730258989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 0104002014
- Practice address
- 785 Grand Ave
#100
Carlsbad, CA 92008-2370 - Phone
- (760) 729-3200
- Fax
- (760) 729-3201
- NPI assigned
- Nov 6, 2006
- Sex
- Male
- 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 | 0104002014 | VA | Primary |
Addresses
Primary practice location
785 Grand Ave
#100
Carlsbad, CA 92008-2370
Mailing address
PO Box 1176
Cardiff, CA 92007-7176
Phone (760) 908-9053
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30631 | CA | MD | Clinical Psychologist |
| 0104002014 | VA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Publico Chiropractic in | Chiropractor | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Chiropractor
- Carlsbad, CA
- NPI 1275880221
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370908800000",
"number": "1730258989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1176",
"city": "CARDIFF",
"state": "CA",
"postal_code": "920077176",
"telephone_number": "760-908-9053",
"fax_number": "760-729-3201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "785 GRAND AVE",
"address_2": "#100",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920082370",
"telephone_number": "760-729-3200",
"fax_number": "760-729-3201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINNEAR",
"first_name": "CLINTON",
"middle_name": "LANE",
"name_prefix": "Mr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-06",
"last_updated": "2013-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "VA",
"license": "0104002014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Carlsbad, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.