Individual provider Active NPI

Wade Glenn Clingan, D.C.

  • Chiropractor
  • Prattville, AL
National Provider Identifier
1811908247
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1948 Issued in AL
Practice address
550 McQueen Smith Rd N
Prattville, AL 36066-5558
Phone
(334) 358-0320
Fax
(334) 358-8923
NPI assigned
Aug 10, 2006
Last updated
Jul 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1948 AL Primary

Addresses

Primary practice location

550 McQueen Smith Rd N
Prattville, AL 36066-5558

Mailing address

550 McQueen Smith Rd N
Prattville, AL 36066-5558
Phone (334) 358-0320

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070122000524 AL Practitioner - Chiropractic 9234130261 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
1948ALMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pmcoa, Inc. Chiropractor CurrentSince Dec 15, 2024 Accepting new patients

Locations

3283 Malcolm Dr
Montgomery, AL 36116
Phone (334) 202-2680

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1811908247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MCQUEEN SMITH RD N",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360665558",
            "telephone_number": "334-358-0320",
            "fax_number": "334-358-8923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MCQUEEN SMITH RD N",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360665558",
            "telephone_number": "334-358-0320",
            "fax_number": "334-358-8923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINGAN",
        "first_name": "WADE",
        "middle_name": "GLENN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "1948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prattville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.