Clouse Chiropractic Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

4560 Issued in AZ

Legal business name

CLOUSE CHIROPRACTIC CLINIC LLC

Practice address

437 S Gilbert Rd Ste 14
Mesa, AZ 85204-2866

Phone

(480) 834-9000

Fax

(480) 834-1880

NPI assigned

Nov 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Russell Leroy Clouse, DC

Title

President/Ceo

Phone

(480) 834-9000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Gerald Craig Godard, DC

  • Nutrition Chiropractor
  • Mesa, AZ
  • NPI 1194727396
  NPD (past)
• Lance Mollenhauer, D.C.

  • Chiropractor
  • Florence, AZ
  • NPI 1912206590
  NPD (past)

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1942481379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 S GILBERT RD STE 14",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852042866",
            "telephone_number": "480-834-9000",
            "fax_number": "480-834-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 S GILBERT RD STE 14",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852042866",
            "telephone_number": "480-834-9000",
            "fax_number": "480-834-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOUSE CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "CLOUSE",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "LEROY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "480-834-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AZ",
            "license": "4560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "AZ0943720",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy David Clipperton, ATC
• Diane Clodi, LPC
• Jessica Clonts
• Kyle Nelson Clonts, PHARMD
• Chad H Close, LISAC
• Glenn Charles Clouse, PSY.D.
• Jordan Clouse, PT
• Russell Leroy Clouse, DC
• Tori Bailey Clouse, CF-SLP
• Nathan John Cloutier, NP-C

• Clinic/Center in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.