Active NPI
Patrick Shawn Clary, D.C.
- Chiropractor
- Arkadelphia, AR
National Provider Identifier
1912932252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1347
- Practice address
- 815 Clinton St
Arkadelphia, AR 71923-5923 - Phone
- (870) 246-2902
- Fax
- (870) 246-3706
- NPI assigned
- Jul 12, 2006
- Last updated
- Aug 14, 2009
- 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 | 1347 | AR | Primary |
Addresses
Primary practice location
815 Clinton St
Arkadelphia, AR 71923-5923
Mailing address
815 Clinton St
Arkadelphia, AR 71923-5923
Phone (870) 246-2902
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060913000596 | AR | Practitioner - Chiropractic | 0547264046 | Practice locations: Arkadelphia, AR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250208000000",
"number": "1912932252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 CLINTON ST",
"city": "ARKADELPHIA",
"state": "AR",
"postal_code": "719235923",
"telephone_number": "870-246-2902",
"fax_number": "870-246-3706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 CLINTON ST",
"city": "ARKADELPHIA",
"state": "AR",
"postal_code": "719235923",
"telephone_number": "870-246-2902",
"fax_number": "870-246-3706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARY",
"first_name": "PATRICK",
"middle_name": "SHAWN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2009-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AR",
"license": "1347",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arkadelphia, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2009; 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.