Clinton Wylie Camacho, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

14636 Issued in TX

Practice address

1218 N Bonnie Brae St Ste 100
Denton, TX 76201-5487

Phone

(940) 382-7425

NPI assigned

Jan 27, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nobility Medical PLLCGroup PAC ID 6002196300, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nobility Medical PLLC

  • Primary Care Clinic/Center
  • Prosper, TX
  • NPI 1730639113

  Multi-Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1891386496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4721 CRAWFORD DR",
            "city": "THE COLONY",
            "state": "TX",
            "postal_code": "750561617",
            "telephone_number": "940-395-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 N BONNIE BRAE ST STE 100",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762015487",
            "telephone_number": "940-382-7425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "CLINTON",
        "middle_name": "WYLIE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "14636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Callahan, BCBA-D
• Priscilla Katherine Callaway, MA, LBA, BCBA
• Callis Investments LLC
• Calm Mind Psychiatry PLLC
• Richard-Michael Calzada, MS, LPC
• Cambrielle Campbell
• Cheryl Edwards Campbell, LCSW; LSOTP, CSAT
• Crystal Paige Campbell, LCSW
• Aisha Campos
• Elaine Veronica Candeloro, CNM

• Chiropractor in Denton, TX
• Providers in Denton, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.

Verify at the official NPI Registry.