Organization Active NPI

Clifton J Clendenan DC PC

  • Chiropractor
  • Imlay City, MI
National Provider Identifier
1891961546
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3201002785 Issued in MI
Legal business name
CLIFTON J CLENDENAN DC PC
Practice address
279 W Capac Rd
Imlay City, MI 48444-1071
Phone
(810) 724-0596
NPI assigned
May 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Authorized official

Name
Dr. Clifton James Clendenan, DC
Title
President
Phone
(810) 724-0596

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3201002785 MI Primary

Addresses

Primary practice location

279 W Capac Rd
Imlay City, MI 48444-1071

Mailing address

PO Box 127
Imlay City, MI 48444-0127
Phone (810) 724-0596

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080618000303 MI Part B Supplier - Clinic/Group Practice 1153492194 Receives reassigned benefits from 1 practitioner
Practice locations: Imlay City, MI

National Provider Directory

National Provider Directory

Locations

279 W Capac Rd
Imlay City, MI 48444
Phone (810) 724-0596

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209686400000",
    "number": "1891961546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 127",
            "city": "IMLAY CITY",
            "state": "MI",
            "postal_code": "484440127",
            "telephone_number": "810-724-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 W CAPAC RD",
            "city": "IMLAY CITY",
            "state": "MI",
            "postal_code": "484441071",
            "telephone_number": "810-724-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFTON J CLENDENAN DC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-02",
        "last_updated": "2008-05-02",
        "status": "A",
        "authorized_official_last_name": "CLENDENAN",
        "authorized_official_first_name": "CLIFTON",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-724-0596",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "3201002785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Imlay City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; 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.